Healthcare Provider Details

I. General information

NPI: 1104985563
Provider Name (Legal Business Name): FELIX VILLAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE WASHINGTON ASHFORD MEDICAL CENTER SUITE 807
SAN JUAN PR
00907-1510
US

IV. Provider business mailing address

29 CALLE WASHINGTON ASHFORD MEDICAL CENTER SUITE 807
SAN JUAN PR
00907-1510
US

V. Phone/Fax

Practice location:
  • Phone: 787-724-4630
  • Fax: 787-724-4630
Mailing address:
  • Phone: 787-724-4630
  • Fax: 787-724-4630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number4903
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: