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NPI Code Detail

MEDICARE: DAVINA MEDICAL CARE, P.A.

MEDICARE: DAVINA MEDICAL CARE, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME84057FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME84057OTHERFLME #

General Provider Information

NPI Number : 1053363697
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVINA MEDICAL CARE, P.A.
Provider Business Mailing Address
First Line : 151 NW 11TH ST
Second Line : SUITE: E-304
City : HOMESTEAD
State : FL
Zip : 33030-4360
Country : US
Telephone Number : 305-245-8787
Fax Number : 305-245-8778
Provider Business Practice Location Address
First Line : 151 NW 11TH ST
Second Line : SUITE: E-304
City : HOMESTEAD
State : FL
Zip : 33030-4360
Country : US
Telephone Number : 305-245-8787
Fax Number : 305-245-8778
Authorized Official
Title or Position : DOCTOR
Name : DR. LUISA M LOPEZ-LUCIANO
Credential : M.D.
Telephone Number : 305-245-8787
Provider Enumeration Date : 05/16/2006
Last Update Date : 03/07/2023

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Directions to “DAVINA MEDICAL CARE, P.A. ” Practice Location

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