Provider Demographics
NPI:1558928051
Name:DAVILA PLAZA, GERALDINE R (MD)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:R
Last Name:DAVILA PLAZA
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:COND VILLA LOS FILTROS APT A2
Mailing Address - Street 2:CARR 833
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-461-9058
Mailing Address - Fax:
Practice Address - Street 1:107 CALLE PADRE LAS CASAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3104
Practice Address - Country:US
Practice Address - Phone:787-200-7842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24599208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice