Provider Demographics
NPI:1215818596
Name:RODRIGUEZ DAVILA, GUSTAVO ADOLFO
Entity type:Individual
Prefix:MR
First Name:GUSTAVO
Middle Name:ADOLFO
Last Name:RODRIGUEZ DAVILA
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:URB. PERLA DEL SUR, CALLE COMPARSA , #2529
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:939-245-5670
Mailing Address - Fax:
Practice Address - Street 1:URB. PERLA DEL SUR, CALLE COMPARSA , #2529
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:939-245-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program