Provider Demographics
NPI:1366672248
Name:CHAPA DAVILA, JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:CHAPA DAVILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAVIER
Other - Middle Name:
Other - Last Name:CHAPA DAVILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 CARR 165 STE 311
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-8050
Mailing Address - Country:US
Mailing Address - Phone:787-224-9188
Mailing Address - Fax:939-437-4302
Practice Address - Street 1:CENTRO INTERNACIONAL DE MERCADEO CARR 165
Practice Address - Street 2:TORRE 1 SUITE 311
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00096
Practice Address - Country:US
Practice Address - Phone:787-224-9188
Practice Address - Fax:939-437-4302
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-25
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR182122084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18212OtherLIC MD