Healthcare Provider Details

I. General information

NPI: 1184797482
Provider Name (Legal Business Name): MIGUEL A DAVILA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 ORLANDO CENTRAL PKWY STE 480
ORLANDO FL
32809-5785
US

IV. Provider business mailing address

1707 ORLANDO CENTRAL PKWY STE 480
ORLANDO FL
32809-5785
US

V. Phone/Fax

Practice location:
  • Phone: 407-382-9079
  • Fax:
Mailing address:
  • Phone: 407-382-9079
  • Fax: 407-964-1274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberACN916
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN916
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number15988
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: