Doctor Name: | MR. LUIS I DAVILA GONZALEZ |
NPI Number: | 1518035435 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 5597 |
Business Practice Address: | Carretera 159 Km 150 B0 Pueblo Corozal, PR - 007830840 |
Business Phone Number: | 7878591520 |
Business Fax Number: | 7878591520 |
Mailing Address: | Po Box 840, COROZAL |
State: | PR |
Postal Code: | 007830840 |
Phone Number: | 7878591520 |
Fax Number: | 7878591520 |
NPI Enumeration Date: | 11/30/2006 |
NPI Last Update Date: | 08/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5597 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |