Provider Demographics
NPI:1538124664
Name:HEAL, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HEAL
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 1:577 CALLE TORRECILLAS
Mailing Address - Street 2:URB. SUMMIT HILLS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-3111
Practice Address - Country:US
Practice Address - Phone:787-654-9100
Practice Address - Fax:787-654-8425
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15876208D00000X
FLACN1013208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRPG-4862OtherPALIC
PR23077HEOtherTRIPLE-S
PR9090180OtherHUMANA
PR31-15876OtherUIA
PR100766OtherCRUZ AZUL
PR61101OtherHUMANA GOLD CHOICE
PR119-15876OtherGLOBAL HEALTH PLAN
FLBH9194983OtherDEA
PRPG-4862OtherPALIC
PR119-15876OtherGLOBAL HEALTH PLAN
002-3077Medicare ID - Type Unspecified