Rafael A Davila Micheo, MD, EIT
Individual provider Active NPI General Practice Physician · San Juan, PR
NPI 1003328808 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1003328808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 22423 (PR)
- Practice address
- Centro Medico de Puerto Rico
San Juan, PR 00935-0001 - Phone
- (787) 777-3535
- NPI assigned
- Nov 2, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230828002118 | PR | Practitioner - General Practice | 0840653689 |
Reassigns benefits to 1 organization Practice locations: Corozal, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15588-I | PR | MD | General Practice Physician |
| 22423 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inspira Behavioral Care Corp. | Current | Accepting new patients | |
| Inspira Behavioral Care Corp. | General Practice | Current |
Accepting new patients |
| Inspira Behavioral Care Corp | Current |
Accepting new patients | |
| Urrutia Womens Health & Maternity Care LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 15588-I | PR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 22423 | PR | Yes |
Addresses
Primary practice location
Centro Medico de Puerto Rico
San Juan, PR 00935-0001
Mailing address
710 Ave Fernandez Juncos Apt 4
San Juan, PR 00907-4211
Phone (787) 318-3064
Other practice location 1
University of Puerto Rico Medical Sciences Campus
San Juan, PR 00936
Phone (787) 758-2525
Other practice location 2
Barrio Monacillos Hospital Oncologico
San Juan, PR 00935-0001
Phone (787) 763-4149
Other providers in San Juan, PR
- Patricia Isabel Davila Cardona
- Nicolle Davila Castrodad
- Natasha Carolina Davila Corujo
- Andres Emmanuel Davila Figueroa
- Luis A Davila Gonzalez
- Joshua Jared Davila Perez
- Priscilla Marie Davila Perez
- Geraldine R Davila Plaza
- Keishla M Davila Rivera
- Mayra E. Davila Rivera
All providers in San Juan, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.