Provider Demographics
NPI:1275660409
Name:DAVILA, ANA MERCEDES
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:MERCEDES
Last Name:DAVILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXT LLANOS DE GURABO CALLE AZUCENA
Mailing Address - Street 2:1412
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-712-1367
Mailing Address - Fax:
Practice Address - Street 1:CALLE CELIS AGUILERA
Practice Address - Street 2:74
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-3075
Practice Address - Fax:787-744-3075
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004101183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician