Provider Demographics
NPI:1740352160
Name:COYA VILLARAOS, GLORIA E (MD)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:E
Last Name:COYA VILLARAOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7953
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732
Mailing Address - Country:US
Mailing Address - Phone:787-835-2870
Mailing Address - Fax:787-835-2870
Practice Address - Street 1:27 CALLE RUFINA
Practice Address - Street 2:
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656-1720
Practice Address - Country:US
Practice Address - Phone:787-835-2870
Practice Address - Fax:787-835-2870
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0083764Medicare ID - Type Unspecified
F81644Medicare UPIN