Provider Demographics
NPI:1497701502
Name:JUAN E. BATISTA, MD, PA
Entity Type:Organization
Organization Name:JUAN E. BATISTA, MD, PA
Other - Org Name:RAFAEL O. NUNEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-964-1181
Mailing Address - Street 1:1840 FOREST HILL BLVD
Mailing Address - Street 2:101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6063
Mailing Address - Country:US
Mailing Address - Phone:561-964-1181
Mailing Address - Fax:
Practice Address - Street 1:1840 FOREST HILL BLVD
Practice Address - Street 2:101
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6063
Practice Address - Country:US
Practice Address - Phone:561-964-1181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076971261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271119200Medicaid