Provider Demographics
NPI:1720130214
Name:DRA. BRUNILDA BABILONIA GENERAL MEDICINE PSC
Entity Type:Organization
Organization Name:DRA. BRUNILDA BABILONIA GENERAL MEDICINE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUNILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABILONIA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-806-0050
Mailing Address - Street 1:PO BOX 3879
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-3879
Mailing Address - Country:US
Mailing Address - Phone:787-806-0050
Mailing Address - Fax:787-806-0091
Practice Address - Street 1:26 CALLE DE DIEGO W
Practice Address - Street 2:EDIFICIO CESANI OFF. 101
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4701
Practice Address - Country:US
Practice Address - Phone:787-806-0050
Practice Address - Fax:787-806-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0025207Medicare ID - Type Unspecified
PRF35605Medicare UPIN