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A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Vascular Surgery |
2086S0129X | 76 | Physician/Peripheral Vascular Disease | |
Thoracic Surgery (Cardiothoracic Vascular Surgery) |
208G00000X | 02 | Physician/General Surgery |
| NPI # | 1548532088 |
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| LBN Legal business name | ANTONIO G. REVILLA JR., M.D. P.A. | ||||
| Authorized official | ANTONIO REVILLA - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/30/2012 | ||||
| Last updated | 02/17/2012 - About 14 years ago | ||||
| Identifiers |
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ANTONIO G. REVILLA JR., M.D. P.A.