Provider Demographics
NPI:1558063198
Name:DAVILA PEREZ, PRISCILLA MARIE
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:MARIE
Last Name:DAVILA PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321B CALLE CLEMSON
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DR. JOSE CELSO BARBOSA
Practice Address - Street 2:MEDICAL SCHOOL, UPR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4020
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17570208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice