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General NPI Number Information
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NPI Number | 1003328808
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Entity Type | Individual
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Provider Name | RAFAEL A DAVILA MICHEO MD, EIT
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Gender | Male
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | CENTRO MEDICO DE PUERTO RICO
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City | SAN JUAN
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State | PR
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Zip | 00935-0001
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Country | US
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Telephone | 787-777-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 710 AVE FERNANDEZ JUNCOS APT 4
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City | SAN JUAN
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State | PR
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Zip | 00907-4211
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Country | US
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Telephone | 787-318-3064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15588-I
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 22423
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License Number State | PR
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