Healthcare Provider Details

I. General information

NPI: 1750451704
Provider Name (Legal Business Name): TELECOM DOCTORS, CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOS PASEOS MALL STE. 108A
SAN JUAN PR
00926-8250
US

IV. Provider business mailing address

PO BOX 70250 STE. 356
SAN JUAN PR
00936-8250
US

V. Phone/Fax

Practice location:
  • Phone: 787-748-5306
  • Fax: 787-748-5297
Mailing address:
  • Phone: 787-748-5306
  • Fax: 787-748-5297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE AURELIO DAVILA
Title or Position: MEDICAL DIRECTOR & CEO
Credential: MD
Phone: 787-748-5306