JACY VILLA (NPI# 1811995434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811995434 |
| Entity Type | Individual |
| Full Name | JACY VILLA |
| Credential | M.D. |
| Practice Address |
2623 S Seacrest Blvd Suite 216 Boynton Beach FL 33435-7501 |
| Mailing Address |
2234 Colonial Blvd Attn: Payer Contracting & Relations Dept. Fort Myers FL 33907-1412 |
| Practice Telephone | 5617420065 |
| Practice Fax Number | 5617420105 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2016-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
ME80441 | FL | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
ME80441 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | OPTIMUM | P971389 | 01 |
| FL | DIMENSION | 14392 | 01 |
| FL | AETNA | 5753526 | 01 |
| FL | BCBS | 57987 | 01 |
| FL | RR MEDICARE | P01594402 | 01 |
| FL | FREEDOM | P1035622 | 01 |
| FL | CIGNA | 8490121 | 01 |
| FL | AVMED | 279218 | 01 |
| Street Address |
2623 S SEACREST BLVD SUITE 216 |
| City | BOYNTON BEACH |
| State | FL |
| Zip Code | 33435-7501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915636 | Rogelio A Brito | Internal Medicine | 2623 S Seacrest Blvd, Suite 216, Boynton Beach, FL 33435-7501 | 2005-07-08 |
| 1376003467 | Anika Bethel | Internal Medicine | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2019-03-23 |
| 1720574742 | Anitha Chandran | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435 | 2018-07-02 |
| 1356847933 | Sanja Hotic Patino | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-04-03 |
| 1134625981 | Oladipo Bankole Cole | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-04-02 |
| 1821594516 | Wayne Fluss | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-04-02 |
| 1205331352 | Kendall Rae Johnson | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-03-29 |
| 1184129207 | Lilibeth Jauregui | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-03-29 |
| 1720583974 | David Lloyd Waldburg V | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-03-29 |
| 1437654662 | Eric Joseph Chacko | Student in an Organized Health Care Education/Training Program | 2623 S Seacrest Blvd, Boynton Beach, FL 33435-7501 | 2018-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824186 | Sarah Gostich | Podiatrist | 2815 S Searest Blvd, Boynton Beach, FL 33435 | 2019-08-01 |
| 1104487768 | Amira Nabil Halim Ibrahim | Student in an Organized Health Care Education/Training Program | Florida Atlantic University Medicine-bethesda Hospital, 2623 S Seacrest Blvd, Boynton Beach, FL 33435 | 2019-06-25 |
| 1972064491 | Elizabeth Anita Calhoun | Emergency Medicine | Bethesda Hospital East, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-27 |
| 1164983086 | Thomas Rex Peterson | Emergency Medicine | Fau Emergency Medicine, Bethesda Hospital East, Attn: Joanne Daly, 2815 S. Seacrest Blvd., Boynton Beach, FL 33435 | 2019-03-26 |
| 1033686068 | Valery L. Petit-homme | Behavior Technician | 515 Se 20th Ave, Apt 10a, Boynton Beach, FL 33435 | 2018-10-29 |
| 1104391648 | Summit Detox | Psychiatry & Neurology | 3330 S. Federal Highway, 3rd Floor, Boynton Beach, FL 33435 | 2018-10-11 |
| 1184120008 | Zachariah Hatoum | Student in an Organized Health Care Education/Training Program | 2815 South Seacrest Blvd., Gme Suite Lower Level B, Boynton Beach, FL 33435 | 2018-03-30 |
| 1922503135 | Anneka Mariesha Hutton | Student in an Organized Health Care Education/Training Program | 2623 South Seacrest Boulevard, Florida Atlantic University Medicine At Bethesda Hospit, Boynton Beach, FL 33435 | 2018-03-28 |
| 1477079473 | Benezon LLC | Case Management | 609 Manatee Bay Drive, Boynton Beach, FL 33435 | 2017-08-21 |
| 1750814091 | Maria Mijares | Student in an Organized Health Care Education/Training Program | 2623 South Seacrest Blvd., Suite 100, Fau Medicine At Bhe, Boynton Beach, FL 33435 | 2017-04-04 |
| Find all providers in zip 33435 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154452035 | Hematology Oncology Associates of The Palm Beaches | Internal Medicine | 2300 S Congress Ave Ste 103, Boynton Beach, FL 33426-7400 | 2007-03-09 |
| 1043328446 | Stefan Berger | Internal Medicine | 12170 Bear River Rd, Boynton Beach, FL 33473-4970 | 2006-08-26 |
| 1013915636 | Rogelio A Brito | Internal Medicine | 2623 S Seacrest Blvd, Suite 216, Boynton Beach, FL 33435-7501 | 2005-07-08 |
| 1386012615 | Genesiscare Usa of Florida LLC | Internal Medicine | 2623 S Seacrest Blvd, Suite 216, Boynton Beach, FL 33435-7501 | 2015-09-03 |
| 1689747487 | Dipnarine Maharaj | Internal Medicine | 10301 Hagen Ranch Rd, Suite # 600, Boynton Beach, FL 33437-3724 | 2006-11-17 |
| 1417976457 | Angelina S The | Internal Medicine | 2240 W Woolbright Rd, Suite 415, Boynton Beach, FL 33426-6332 | 2006-07-19 |
| 1083665269 | Victor S Koo | Internal Medicine | 2623 S Seacrest Blvd, Suite 216, Boynton Beach, FL 33435-7501 | 2006-05-13 |
| 1902895360 | Mindy S Bohrer | Internal Medicine | 2623 S Seacrest Blvd, Sute 216, Boynton Beach, FL 33435-7501 | 2005-10-18 |
| 1326046947 | Felix A Rodriguez-pinero | Internal Medicine | 2623 S Seacrest Blvd, Suite 216, Boynton Beach, FL 33435-7501 | 2005-07-08 |
| 1437157062 | Hematology and Medical Oncology of Southern Palm Beach County Inc | Internal Medicine | 2623 S Seacrest Blvd, Suite 216, Boynton Beach, FL 33435-7501 | 2005-07-08 |
| Find all providers in BOYNTON BEACH | ||||
| City | BOYNTON BEACH |
| Zip Code | 33435 |
Please comment or provide details below to improve the information on JACY VILLA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.