| Physicians Of Hollywood, Llc | |
|
5201 Hollywood Blvd Hollywood FL 33021-6422 | |
| (954) 716-9114 | |
| Not Available |
| Full Name | Physicians Of Hollywood, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5201 Hollywood Blvd, Hollywood, Florida |
| Authorized Official Name and Position | Ileana A Vila (MEDICAL DOCTOR) |
| Authorized Official Contact | 9547169114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Of Hollywood, Llc 5201 Hollywood Blvd Hollywood FL 33021-6422 Ph: (954) 716-9114 | Physicians Of Hollywood, Llc 5201 Hollywood Blvd Hollywood FL 33021-6422 Ph: (954) 716-9114 |
| NPI Number | 1144856626 |
|---|---|
| Provider Enumeration Date | 03/17/2020 |
| Last Update Date | 03/17/2020 |
| Medicare PECOS PAC ID | 5496172116 |
|---|---|
| Medicare Enrollment ID | O20200826002495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144856626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ileana A Vila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902891054 PECOS PAC ID: 1456543545 Enrollment ID: I20101007000727 |
| Provider Name | Manuel D Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497740112 PECOS PAC ID: 0749256428 Enrollment ID: I20101112001205 |
| Provider Name | Eric Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023575024 PECOS PAC ID: 9931439247 Enrollment ID: I20191001000104 |
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