Provider Demographics
NPI:1023099462
Name:DAVILA, JOSE J (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:DAVILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7600 S RED RD STE 229
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5408
Mailing Address - Country:US
Mailing Address - Phone:305-448-9018
Mailing Address - Fax:305-448-1895
Practice Address - Street 1:62 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1115
Practice Address - Country:US
Practice Address - Phone:321-527-7424
Practice Address - Fax:321-843-2196
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057230207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL590968885OtherHUMANA
FL376055300Medicaid
FL10396OtherB/C & B/S OF FL
FL590968885OtherHUMANA
FL10396ZMedicare ID - Type Unspecified