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General NPI Number Information
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NPI Number | 1184730376
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Entity Type | Individual
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Provider Name | ANGEL MANUEL DAVILA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1462 CALLE PROF AUGUSTO RODRIGUE PAVIA HOSPITAL
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City | SAN JUAN
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State | PR
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Zip | 00909-2145
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Country | US
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Telephone | 787-727-0101
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Fax | 787-728-2641
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Provider Business Mailing Address
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Address Line | W5-18 CALLE CERVANTES HUCARES
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City | SAN JUAN
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State | PR
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Zip | 00926-6804
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Country | US
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Telephone | 787-283-2118
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Fax | 787-283-2118
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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 | 10304
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License Number State | PR
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