Roberto Davila, LIC OPTICIAN DO
Individual provider Active NPI Optician · San Juan, PR
NPI 1215034749 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1215034749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 011 (PR)
- Practice address
- Reparto San Jose Almagro St 388
San Juan, PR 00923-1245 - Phone
- (787) 531-2777
- Fax
- (787) 763-5667
- NPI assigned
- Sep 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011 | PR | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 011 | PR | Yes |
Addresses
Primary practice location
Reparto San Jose Almagro St 388
San Juan, PR 00923-1245
Mailing address
Reparto San Jose Almagro St 388
San Juan, PR 00923-1245
Phone (787) 531-2777
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.