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General NPI Number Information
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NPI Number | 1427221852
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Entity Type | Individual
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Provider Name | RAUL JOSE VILLACOB-ROCA MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 160 NW 170TH ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-5521
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Country | US
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Telephone | 305-651-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CORPORATE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70508-3870
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Country | US
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Telephone | 800-893-9698
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Fax |
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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 | 265099
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME100523
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME 100523
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License Number State | FL
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