Palm Beach Cardiovascular Clinic LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME50208 Issued in FL

Legal business name

PALM BEACH CARDIOVASCULAR CLINIC LLC

Practice address

3385 Burns Rd
Suite 108
Palm Beach Gardens, FL 33410-4328

Phone

(561) 627-2210

Fax

(561) 627-2210

NPI assigned

Dec 3, 2007

Organization subpart

No

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 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gail Ann Combs, PA-C

  • Physician Assistant
  • Anchorage, AK
  • NPI 1134439896
  NPD
• Samuel Jason Kapnick, M.D.

  • Gynecologic Oncology Physician
  • Pensacola, FL
  • NPI 1760452502
  NPD (past)
• Joshua L Luce, M.D.

  • Cardiovascular Disease Physician
  • Wausau, WI
  • NPI 1780600668

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1689856528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY BLVD",
            "address_2": "SUITE 200",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582778",
            "telephone_number": "561-627-2210",
            "fax_number": "561-627-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 BURNS RD",
            "address_2": "SUITE 108",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104328",
            "telephone_number": "561-627-2210",
            "fax_number": "561-627-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH CARDIOVASCULAR CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2008-02-04",
        "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 SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME50208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "21776",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Palm Beach Gardens, FL
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.