Provider Demographics
NPI:1508070186
Name:DAVILA TORRES, NOEL
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:DAVILA TORRES
Suffix:
Gender:M
Credentials:
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 363463
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3463
Mailing Address - Country:US
Mailing Address - Phone:787-531-5348
Mailing Address - Fax:787-701-1207
Practice Address - Street 1:FARMACIA SANTA RITA
Practice Address - Street 2:CARR. NO.2 KM. 29.6
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-0033
Practice Address - Country:US
Practice Address - Phone:787-883-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist