Provider Demographics
NPI:1922594258
Name:OMEGA BEHAVIORCARE, P.A.
Entity Type:Organization
Organization Name:OMEGA BEHAVIORCARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILVAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-540-3808
Mailing Address - Street 1:PO BOX 741482
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33474-1482
Mailing Address - Country:US
Mailing Address - Phone:904-540-3808
Mailing Address - Fax:
Practice Address - Street 1:9974 EQUUS CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-4320
Practice Address - Country:US
Practice Address - Phone:904-540-3808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME783042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0007803016OtherAETNA
FLP01412336OtherMEDICARE RR- PTAN
FL49862OtherBCBS FL
FL2062792OtherCIGNA
FLE3261ROtherMEDICARE P-TAN