| Davila Medical Center Inc | |
|
4315 Nw 7th St Ste 47 Miami FL 33126-3561 | |
| (305) 441-2760 | |
| (305) 441-2762 |
| Full Name | Davila Medical Center Inc |
|---|---|
| Speciality | General Practice |
| Location | 4315 Nw 7th St Ste 47, Miami, Florida |
| Authorized Official Name and Position | Jose A Davila (PRESIDENT) |
| Authorized Official Contact | 7863706869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Davila Medical Center Inc 4315 Nw 7th St Ste 47 Miami FL 33126-3561 Ph: (305) 441-2760 | Davila Medical Center Inc 4315 Nw 7th St Ste 47 Miami FL 33126-3561 Ph: (305) 441-2760 |
| NPI Number | 1902113939 |
|---|---|
| Provider Enumeration Date | 09/13/2010 |
| Last Update Date | 06/15/2023 |
| Medicare PECOS PAC ID | 5991002362 |
|---|---|
| Medicare Enrollment ID | O20160330000750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902113939 | NPI | - | NPPES |
| Provider Name | Lazaro H Cordoves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821126079 PECOS PAC ID: 9133139009 Enrollment ID: I20060424000159 |
| Provider Name | Jorge Betancourt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982707998 PECOS PAC ID: 7012177702 Enrollment ID: I20120404000985 |
| Provider Name | Ivan Dieguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1144879495 PECOS PAC ID: 8527495118 Enrollment ID: I20200220000464 |
| Provider Name | Jason Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659802916 PECOS PAC ID: 9335549518 Enrollment ID: I20210609001412 |
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