MEDICARE: DR. RAUL G VILA RAMIREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	13276	PR

General Provider Information

NPI Number	:	1013988815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAUL G VILA RAMIREZ MD

Provider Business Mailing Address
First Line	:	735 AVE PONCE DE LEON
Second Line	:	SUITE 407
City	:	SAN JUAN
State	:	PR
Zip	:	00917-5022
Country	:	US
Telephone Number	:	787-773-0533
Fax Number	:	787-773-0534

Provider Business Practice Location Address
First Line	:	735 AVE PONCE DE LEON
Second Line	:	SUITE 407
City	:	SAN JUAN
State	:	PR
Zip	:	00917-5022
Country	:	US
Telephone Number	:	787-773-0533
Fax Number	:	787-773-0534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	04/27/2016

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