Individual
MR. ROBERTO LUIS DAVILA-DEPEDRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
5154
PR
207ND0101X
MOHS-Micrographic Surgery Physician
5154
PR
207NS0135X
Procedural Dermatology Physician
5154
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27404
MEDICAL CARD SYSTEM
PR
Enumeration date
09/16/2005
Last updated
04/13/2022
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