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General NPI Number Information
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NPI Number | 1518748797
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Entity Type | Individual
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Provider Name | SERGIO ANDRES DAVILA SANTANA PHD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 203 CALLE ELEONOR ROOSEVELT
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City | SAN JUAN
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State | PR
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Zip | 00918-3010
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Country | US
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Telephone | 787-639-5779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 695
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City | CATANO
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State | PR
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Zip | 00963-0695
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Country | US
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Telephone | 787-639-5779
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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 | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7682
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License Number State | PR
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