Individual
MRS. LOURDES IVETTE DAVILA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
13 WILLIE ROSARIO, SUITE 2, COAMO, PR 00769
(787) 825-5458
(787) 803-1993
Mailing address
13 CALLE WILLIE ROSARIO, SUITE 2, COAMO, PR 00769-3252
(787) 825-5458
(787) 803-1993
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
197
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2200033
HUMANA
—
01
—
38275
PROSSAM
—
01
—
58026
SSS
—
01
—
660446068
MAPFRE
PR
01
—
660446068
MCS OPTICA
—
01
—
890037
MMM
—
01
—
M000590
MENONITA
—
Enumeration date
10/03/2006
Last updated
10/15/2018
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