MEDICARE: GABRIELA LIMARY DAVILA RIVERA

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
1	152W00000X	Optometrist	413835	WI

General Provider Information

NPI Number	:	1891629523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA LIMARY DAVILA RIVERA

Provider Business Mailing Address
First Line	:	10150 S WINDSOR DR
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-5580
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 W LAYTON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-5310
Country	:	US
Telephone Number	:	414-325-8600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ GABRIELA LIMARY DAVILA RIVERA ” Practice Location

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