Provider Demographics
NPI:1205247368
Name:TIRADO-DAVILA, FELIPE (MD,)
Entity type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:
Last Name:TIRADO-DAVILA
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 1:201 URB LAS PALMAS
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-2427
Mailing Address - Country:US
Mailing Address - Phone:787-644-6681
Mailing Address - Fax:
Practice Address - Street 1:25 CALLE LUIS MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1892
Practice Address - Country:US
Practice Address - Phone:787-978-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR187012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry