Healthcare Provider Details

I. General information

NPI: 1427261973
Provider Name (Legal Business Name): DR. WILLIAM DAVILA MUNTANER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE MARGINAL KMM 859 CARR #2
HATILLO PR
00659
US

IV. Provider business mailing address

BOX 591
UTUADO PR
00641
US

V. Phone/Fax

Practice location:
  • Phone: 787-820-0207
  • Fax: 787-820-0207
Mailing address:
  • Phone: 787-820-0207
  • Fax: 787-820-0207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number10978
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: