Individual provider Active NPI

Guillermo Vila-Sotomayor, MD

  • Pediatrics Physician
  • West Palm Beach, FL
National Provider Identifier
1124097761
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 59360 Issued in FL
Practice address
901 45TH St
West Palm Beach, FL 33407-2413
Phone
(561) 844-6300
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 59360 FL Primary

Addresses

Primary practice location

901 45TH St
West Palm Beach, FL 33407-2413

Mailing address

4961 Elsworth Way
West Palm Beach, FL 33417-8227
Phone (561) 848-8701

Other identifiers 1

IdentifierTypeStateIssuer
14761OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 59360FLMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124097761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4961 ELSWORTH WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334178227",
            "telephone_number": "561-848-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILA-SOTOMAYOR",
        "first_name": "GUILLERMO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 59360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14761",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.