| Obct Md | |
|
125 W Indiantown Rd Ste 203b Jupiter FL 33458-3539 | |
| (313) 515-0710 | |
| (888) 494-2192 |
| Full Name | Obct Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 125 W Indiantown Rd Ste 203b, Jupiter, Florida |
| Authorized Official Name and Position | Lucero Cecilia Chueca Villa (MANAGER) |
| Authorized Official Contact | 3135150710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Obct Md 125 W Indiantown Rd Ste 203b Jupiter FL 33458-3539 Ph: (313) 515-0710 | Obct Md 125 W Indiantown Rd Ste 203b Jupiter FL 33458-3539 Ph: (313) 515-0710 |
| NPI Number | 1063100550 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 09/07/2023 |
| Medicare PECOS PAC ID | 2365897907 |
|---|---|
| Medicare Enrollment ID | O20231017001341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063100550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lucero Chueca Villa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992969075 PECOS PAC ID: 6608048566 Enrollment ID: I20160520001968 |
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