Provider Demographics
NPI:1104985563
Name:VILLAR, FELIX
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:VILLAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CALLE WASHINGTON
Mailing Address - Street 2:ASHFORD MEDICAL CENTER SUITE 807
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1510
Mailing Address - Country:US
Mailing Address - Phone:787-724-4630
Mailing Address - Fax:787-724-4630
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:ASHFORD MEDICAL CENTER SUITE 807
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-724-4630
Practice Address - Fax:787-724-4630
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4903173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC78152Medicare UPIN