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General NPI Number Information
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NPI Number | 1902113939
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Entity Type | Organization
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Legal Business Name | DAVILA MEDICAL CENTER INC
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 4315 NW 7TH ST STE 47
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City | MIAMI
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State | FL
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Zip | 33126-3561
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Country | US
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Telephone | 305-441-2760
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Fax | 305-441-2762
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Provider Business Mailing Address
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Address Line | 4315 NW 7TH ST STE 47
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City | MIAMI
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State | FL
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Zip | 33126-3561
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Country | US
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Telephone | 305-441-2760
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Fax | 305-441-2762
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE A DAVILA
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Credential |
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Telephone | 786-370-6869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | HCC8852
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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