Provider Demographics
NPI:1386729598
Name:TOME VILA, JAIME EMILIO (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:EMILIO
Last Name:TOME VILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 70321
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8321
Mailing Address - Country:US
Mailing Address - Phone:787-764-5666
Mailing Address - Fax:787-767-7040
Practice Address - Street 1:400 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE 109
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-764-5666
Practice Address - Fax:787-767-7040
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2019-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR128882085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG25262Medicare UPIN