Provider Demographics
NPI:1992269468
Name:RHEUMATOLOGY CENTER OF PALM BEACH PLLC
Entity type:Organization
Organization Name:RHEUMATOLOGY CENTER OF PALM BEACH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYA VILLAMIZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-688-6996
Mailing Address - Street 1:PO BOX 8689
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-8689
Mailing Address - Country:US
Mailing Address - Phone:561-748-2889
Mailing Address - Fax:561-748-1523
Practice Address - Street 1:3918 VIA POINCIANA STE 2
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2991
Practice Address - Country:US
Practice Address - Phone:561-969-1261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty