MEDICARE: DR. SALVADOR VILA M.D.

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	207RR0500X	Rheumatology Physician	7064	PR

General Provider Information

NPI Number	:	1538117684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVADOR VILA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 192349
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-2349
Country	:	US
Telephone Number	:	787-793-8962
Fax Number	:

Provider Business Practice Location Address
First Line	:	735 PONCE DE LEON AVENUE
Second Line	:	SUITE 507
City	:	SAN JUAN
State	:	PR
Zip	:	00917-5026
Country	:	US
Telephone Number	:	787-767-6340
Fax Number	:	787-753-4935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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