Healthcare Provider Details

I. General information

NPI: 1073536983
Provider Name (Legal Business Name): ANA I DAVILA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANA I DAVILA OTR

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 3 BOX 18348
RIO GRANDE PR
00745-9749
US

IV. Provider business mailing address

HC 03 BOX 18348
RIO GRANDE PR
00745-9718
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax: 787-641-4569
Mailing address:
  • Phone: 787-641-7582
  • Fax: 787-641-4569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number459
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: