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General NPI Number Information
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NPI Number | 1205247368
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Entity Type | Individual
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Provider Name | FELIPE TIRADO-DAVILA M.D,
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Gender | Male
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 25 CALLE LUIS MUNOZ RIVERA
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City | SABANA GRANDE
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State | PR
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Zip | 00637-1892
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Country | US
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Telephone | 787-978-7216
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Fax |
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Provider Business Mailing Address
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Address Line | 201 URB LAS PALMAS
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City | SABANA GRANDE
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State | PR
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Zip | 00637-2427
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Country | US
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Telephone | 787-644-6681
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18701
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License Number State | PR
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