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NPI Code Detail

MEDICARE: GERALDINE R DAVILA PLAZA MD

MEDICARE: GERALDINE R DAVILA PLAZA 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
1208D00000XGeneral Practice Physician24599PR

General Provider Information

NPI Number : 1558928051
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALDINE R DAVILA PLAZA MD
Provider Business Mailing Address
First Line : COND VILLA LOS FILTROS APT A2
Second Line : CARR 833
City : GUAYNABO
State : PR
Zip : 00966
Country : US
Telephone Number : 787-461-9058
Fax Number :
Provider Business Practice Location Address
First Line : 107 CALLE PADRE LAS CASAS
Second Line :
City : SAN JUAN
State : PR
Zip : 00918-3104
Country : US
Telephone Number : 787-200-7842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 08/06/2025

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