MEDICARE: DR. HARRY SEDA VILA 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	208D00000X	General Practice Physician	12242	PR

General Provider Information

NPI Number	:	1689655342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY SEDA VILA MD

Provider Business Mailing Address
First Line	:	PO BOX 72
Second Line	:
City	:	ANASCO
State	:	PR
Zip	:	00610-0072
Country	:	US
Telephone Number	:	787-826-0850
Fax Number	:	787-826-0850

Provider Business Practice Location Address
First Line	:	61 CALLE DAGUEY
Second Line	:
City	:	ANASCO
State	:	PR
Zip	:	00610-2602
Country	:	US
Telephone Number	:	787-826-0850
Fax Number	:	787-826-0850

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	02/14/2017

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