Provider Demographics
NPI:1669361788
Name:DAVILA-GOMEZ, JOSIMAR (OD)
Entity type:Individual
Prefix:DR
First Name:JOSIMAR
Middle Name:
Last Name:DAVILA-GOMEZ
Suffix:
Gender:F
Credentials:OD
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 9033
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-9033
Mailing Address - Country:US
Mailing Address - Phone:939-249-3417
Mailing Address - Fax:877-408-9167
Practice Address - Street 1:REXVILLE TOWN CENTER
Practice Address - Street 2:BUILDING A 4 TOAD 167
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-279-8137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2025152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist