Provider Demographics
NPI:1720336373
Name:PHILIAS, WILLY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLY
Middle Name:
Last Name:PHILIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 LAKE SHORE DR UNIT 502
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-4607
Mailing Address - Country:US
Mailing Address - Phone:786-423-3028
Mailing Address - Fax:561-803-8220
Practice Address - Street 1:2650 LAKE SHORE DR UNIT 502
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-4607
Practice Address - Country:US
Practice Address - Phone:786-423-3028
Practice Address - Fax:561-612-0950
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1235082084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry