| Elizabeth Daquila Md, Llc | |
|
851 Dunlawton Ave Ste 102 Port Orange FL 32127-4234 | |
| (386) 402-7827 | |
| (386) 410-5457 |
| Full Name | Elizabeth Daquila Md, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 851 Dunlawton Ave Ste 102, Port Orange, Florida |
| Authorized Official Name and Position | Shema Burrill (OFFICE MANAGER) |
| Authorized Official Contact | 3864027827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Daquila Md, Llc 851 Dunlawton Ave Ste 102 Port Orange FL 32127-4234 Ph: (386) 402-7827 | Elizabeth Daquila Md, Llc 851 Dunlawton Ave Ste 102 Port Orange FL 32127-4234 Ph: (386) 402-7827 |
| NPI Number | 1154833887 |
|---|---|
| Provider Enumeration Date | 11/03/2017 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 2062770548 |
|---|---|
| Medicare Enrollment ID | O20171212000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154833887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME117878 (Florida) | Primary |
| Provider Name | Elizabeth M Daquila |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952637530 PECOS PAC ID: 5890837389 Enrollment ID: I20131204000810 |
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