Individual provider · Type 1 NPI

Antonio G. Revilla Jr., MD

Specialist · Fort Lauderdale, FL

NPI number 1013934470 Active

Practice location

1880 E Commercial Blvd, Suite 3
Fort Lauderdale, FL 33308-3747

Call (954) 772-0949 Map

Fax (954) 772-0957

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XME21737 (FL)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1013934470

Antonio G. Revilla Jr., MD's National Provider Identifier is 1013934470, issued on Jul 15, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Fort Lauderdale, FL. The record was last updated on Mar 6, 2013.