Healthcare Provider Details

I. General information

NPI: 1538450564
Provider Name (Legal Business Name): ROSEMARY DAVILA-SOLA DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 WEST FLAGLER STREET
MIAMI FL
33135-1257
US

IV. Provider business mailing address

201 178TH DR SUITE 219
SUNNY ISLES BEACH FL
33160-2875
US

V. Phone/Fax

Practice location:
  • Phone: 305-984-1154
  • Fax: 305-642-5213
Mailing address:
  • Phone: 305-984-1154
  • Fax: 305-642-5213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO-01666
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO-0001666
License Number StateFL

VIII. Authorized Official

Name: DR. ROSEMARY DAVILA-SOLA
Title or Position: PRESIDENT
Credential: DPM
Phone: 305-984-1154