Provider Demographics
NPI:1831732734
Name:DAVILA, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:DAVILA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LA ESTANCIA
Mailing Address - Street 2:43 VIA PLACIDA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3074
Mailing Address - Country:US
Mailing Address - Phone:787-383-3247
Mailing Address - Fax:
Practice Address - Street 1:URB. SAGRADO CORAZON
Practice Address - Street 2:AVE. SAN CLAUDIO NO.358
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-598-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG