Provider Demographics
NPI:1265090427
Name:MILAN, VICTOR M SR (NURSE)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:M
Last Name:MILAN
Suffix:SR
Gender:M
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 CALLE RUFINO TAMAYO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6330
Mailing Address - Country:US
Mailing Address - Phone:787-677-9227
Mailing Address - Fax:
Practice Address - Street 1:1923 CALLE RUFINO TAMAYO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6330
Practice Address - Country:US
Practice Address - Phone:787-677-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR035744163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR035744OtherNURSE