Provider Demographics
NPI:1447476924
Name:DAVILA, ZAIDA I (MD)
Entity type:Individual
Prefix:MRS
First Name:ZAIDA
Middle Name:I
Last Name:DAVILA
Suffix:
Gender:F
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:CALLE SANTA LUCIA Q6 SANTA ELVIRA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-656-2445
Mailing Address - Fax:787-656-2445
Practice Address - Street 1:DUFRESNE #6
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-656-2445
Practice Address - Fax:787-656-2445
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15445208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4157OtherAMERICAN HEALTH MEDICARE
PR400371OtherMEDICARE Y MUCHO MAS
PR7260067OtherHUMANA REFORMA
PR23550Medicare ID - Type UnspecifiedMEDICARE