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General NPI Number Information
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NPI Number | 1144660291
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Entity Type | Individual
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Provider Name | JUAN JOSE MAYA VILLAMIZAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 3918 VIA POINCIANA STE 2
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City | LAKE WORTH
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State | FL
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Zip | 33467-2991
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Country | US
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Telephone | 561-439-4682
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Fax | 561-969-3400
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Provider Business Mailing Address
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Address Line | PO BOX 8689
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City | JUPITER
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State | FL
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Zip | 33468-8689
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Country | US
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Telephone | 561-748-2889
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Fax | 561-748-1523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME128061
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME128061
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License Number State | FL
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