Provider Demographics
NPI:1225259047
Name:ANSA VILA, RAMON M (MD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:M
Last Name:ANSA VILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1656
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-876-8244
Mailing Address - Fax:787-256-1855
Practice Address - Street 1:BETANCES NUM. 80
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-8244
Practice Address - Fax:787-256-1855
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6687208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR037653600Medicaid
PR27375Medicare ID - Type Unspecified