Organization
LIVING HEALTHY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANDA ENID DAVILA MD (DUENA)
(787) 707-1983
Entity
Organization
Contact information
Practice address
771 AVE ANDALUCIA, SAN JUAN, PR 00921-1803
(787) 707-1983
(787) 706-8823
Mailing address
PO BOX 51991, TOA BAJA, PR 00950-1991
(787) 707-1983
(787) 706-8823
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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