Provider Demographics
NPI:1104833763
Name:VILLAMIL, MAYRA ARLENE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:ARLENE
Last Name:VILLAMIL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1479 CALLE ROBALO
Mailing Address - Street 2:BAHIA VISTAMAR
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1446
Mailing Address - Country:US
Mailing Address - Phone:787-752-4444
Mailing Address - Fax:787-752-4444
Practice Address - Street 1:1479 CALLE ROBALO
Practice Address - Street 2:BAHIA VISTAMAR
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-1446
Practice Address - Country:US
Practice Address - Phone:787-752-4444
Practice Address - Fax:787-752-4444
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
PR11211208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11211Medicare UPIN