Provider Demographics
NPI:1538117684
Name:VILA, SALVADOR (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:
Last Name: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 192349
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2349
Mailing Address - Country:US
Mailing Address - Phone:787-793-8962
Mailing Address - Fax:
Practice Address - Street 1:735 PONCE DE LEON AVENUE
Practice Address - Street 2:SUITE 507
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5026
Practice Address - Country:US
Practice Address - Phone:787-767-6340
Practice Address - Fax:787-753-4935
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7064207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-8775Medicare ID - Type Unspecified
PRDO8475Medicare UPIN