Provider Demographics
NPI:1073653291
Name:RAUL I VILA MD & ASSOCIATES PA
Entity Type:Organization
Organization Name:RAUL I VILA MD & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:I
Authorized Official - Last Name:VILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-984-8740
Mailing Address - Street 1:2500 SW 75TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2805
Mailing Address - Country:US
Mailing Address - Phone:305-264-5252
Mailing Address - Fax:305-266-1290
Practice Address - Street 1:2500 SW 75TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2805
Practice Address - Country:US
Practice Address - Phone:305-264-5252
Practice Address - Fax:305-266-1290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258695900Medicaid
FL258695901Medicaid
FL258695900Medicaid