NPIMap

Organization Active NPI

Palm Beach Cardiovascular Clinic LLC

  • Cardiovascular Disease Physician
  • Jupiter, FL
National Provider Identifier
1144420852
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
21776 Issued in FL
Legal business name
PALM BEACH CARDIOVASCULAR CLINIC LLC
Practice address
601 University Blvd
Suite 206
Jupiter, FL 33458-2788
Phone
(561) 627-2210
Fax
(561) 627-5850
NPI assigned
Jul 20, 2007
Organization subpart
Yes
Parent organization
PALM BEACH CARDIOVASCULAR CLINIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Authorized official

Name
Dr. Augusto Ernesto Villa, M.D.
Title
President
Phone
(561) 627-2210

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X 21776 FL Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0001X 21776 FL
Interventional Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0011X 21776 FL

Addresses

Primary practice location

601 University Blvd
Suite 206
Jupiter, FL 33458-2788

Mailing address

601 University Blvd
Suite 206
Jupiter, FL 33458-2788
Phone (561) 627-2210

Other identifiers 1

IdentifierTypeStateIssuer
21776OtherFLMEDICARE NUMBER

National Provider Directory

National Provider Directory
Part of
Palm Beach Cardiovascular Clinic L C

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1144420852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 UNIVERSITY BLVD",
            "address_2": "SUITE 206",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582788",
            "telephone_number": "561-627-2210",
            "fax_number": "561-627-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 UNIVERSITY BLVD",
            "address_2": "SUITE 206",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582788",
            "telephone_number": "561-627-2210",
            "fax_number": "561-627-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH CARDIOVASCULAR CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM BEACH CARDIOVASCULAR CLINIC LLC",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "AUGUSTO",
        "authorized_official_middle_name": "ERNESTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-627-2210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "21776",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "21776",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "21776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "21776",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.