Individual
DR. JORGE L. BONILLA DAVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2053 PONCE BY PASS, SUITE 104, PONCE, PR 00717-1306
(787) 848-2885
(787) 848-4496
Mailing address
2053 PONCE BY PASS, SUITE 104, PONCE, PR 00717-1306
(787) 848-2885
(787) 848-4496
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
149
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053303289
—
PR
Enumeration date
08/15/2005
Last updated
01/26/2017
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