Antonio G Revilla JR., MD

NPI #1013934470 in Fort Lauderdale, Florida

Provider Information

NPI Number: 1013934470
Entity Type: Individual
Name: Antonio G Revilla JR., MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MD
Enumeration Date: Jul 15, 2006
Last Updated: Mar 6, 2013

Practice Location

Address: 1880 E COMMERCIAL BLVD
Address 2: SUITE 3
City: Fort Lauderdale
State: Florida
ZIP Code: 33308-3747
Phone: (954) 772-0949

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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