MEDICARE: JUAN E. BATISTA, MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	ME0076971	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497701502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUAN E. BATISTA, MD, PA

Provider Business Mailing Address
First Line	:	1840 FOREST HILL BLVD
Second Line	:	101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6063
Country	:	US
Telephone Number	:	561-964-1181
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 FOREST HILL BLVD
Second Line	:	101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6063
Country	:	US
Telephone Number	:	561-964-1181
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAFAEL O NUNEZ
Credential	:	MD
Telephone Number	:	561-964-1181

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/30/2008

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