Provider Demographics
NPI:1689655342
Name:SEDA VILA, HARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:
Last Name:SEDA 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 72
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0072
Mailing Address - Country:US
Mailing Address - Phone:787-826-0850
Mailing Address - Fax:787-826-0850
Practice Address - Street 1:61 CALLE DAGUEY
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-2602
Practice Address - Country:US
Practice Address - Phone:787-826-0850
Practice Address - Fax:787-826-0850
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12242208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
G44103Medicare UPIN
PR88637Medicare ID - Type Unspecified