Individual provider Active NPI

Blanca I Davila-Monero, M.D.

  • General Practice Physician
  • Loiza, PR
National Provider Identifier
1972579761
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14481 Issued in PR
Practice address
Carr 187 KM. 7.0 Mediania Alta
Loiza, PR 00772-0000
Phone
(787) 876-0519
Fax
(787) 876-0519
NPI assigned
Feb 23, 2006
Last updated
Jun 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14481 PR Primary

Addresses

Primary practice location

Carr 187 KM. 7.0 Mediania Alta
Loiza, PR 00772-0000

Mailing address

Calle 13 H-8 Fair View
Rio Piedras, PR 00926-0000
Phone (787) 768-0966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625000689 PR Practitioner - General Practice 2961488473 Practice locations: Loiza, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14481PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1972579761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 13 H-8 FAIR VIEW",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "009260000",
            "telephone_number": "787-768-0966",
            "fax_number": "787-768-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 187 KM. 7.0 MEDIANIA ALTA",
            "city": "LOIZA",
            "state": "PR",
            "postal_code": "007720000",
            "telephone_number": "787-876-0519",
            "fax_number": "787-876-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA-MONERO",
        "first_name": "BLANCA",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loiza, PR

Sources for this page

Verify at the official NPI Registry.