Provider Demographics
NPI:1073613352
Name:DAVILA-TORRES, JOSE R (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:DAVILA-TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:R
Other - Last Name:DAVILA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:53 CALLE ANDRES GARCIA
Mailing Address - Street 2:INSTITUTO DEL CANCER Y ENFERMEDADES DE LA SANGRE
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4335
Mailing Address - Country:US
Mailing Address - Phone:787-817-4973
Mailing Address - Fax:787-817-4997
Practice Address - Street 1:53 CALLE ANDRES GARCIA
Practice Address - Street 2:INSTITUTO DEL CANCER Y ENFERMEDADES DE LA SANGRE
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4335
Practice Address - Country:US
Practice Address - Phone:787-817-4973
Practice Address - Fax:787-817-4997
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13855207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRCG316ZMedicare PIN
PRI-10925Medicare UPIN