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General NPI Number Information
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NPI Number | 1053564435
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Entity Type | Individual
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Provider Name | CARMEN MILAGROS DAVILA LCDA.
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Gender | Female
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | HC 91 BOX 10197
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City | VEGA ALTA
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State | PR
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Zip | 00692-9655
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Country | US
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Telephone | 787-654-8885
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Fax |
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Provider Business Mailing Address
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Address Line | HC 91 BOX 10197
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City | VEGA ALTA
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State | PR
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Zip | 00692-9655
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Country | US
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Telephone | 787-654-8885
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1167
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License Number State | PR
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