Provider Demographics
NPI:1932196151
Name:VILA, JUAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:C
Last Name:VILA
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 1:3018 AVE ISLA VERDE
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-4843
Mailing Address - Country:US
Mailing Address - Phone:787-726-7438
Mailing Address - Fax:787-726-2827
Practice Address - Street 1:3018 AVE ISLA VERDE
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-4843
Practice Address - Country:US
Practice Address - Phone:787-726-7438
Practice Address - Fax:787-726-2827
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13993207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252001000Medicaid
21025OtherBLUE CROSS BLUE SHIELD
2044245OtherAETNA
225085OtherAVMED
8639264001OtherCIGNA
2505622OtherUNITED HEALTH CARE
FL252001000Medicaid
21025OtherBLUE CROSS BLUE SHIELD