MEDICARE: JUAN R VILARO NELMS 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	8975	PR

General Provider Information

NPI Number	:	1346233871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN R VILARO NELMS MD

Provider Business Mailing Address
First Line	:	STREET 1 NO. 16
Second Line	:	TERRAZAS DE TINTILLO
City	:	GUAYNABO
State	:	PR
Zip	:	00966
Country	:	US
Telephone Number	:	787-281-0122
Fax Number	:	787-753-3596

Provider Business Practice Location Address
First Line	:	TERRAZA DE TINTILLO
Second Line	:	STREET 1 NO 16
City	:	GUAYNABO
State	:	PR
Zip	:	00966
Country	:	US
Telephone Number	:	787-281-0122
Fax Number	:	787-753-3596

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	03/29/2012

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