# ELIZABETH DAQUILA MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154833887
- **Authorized official:** SHEMA BURRILL (OFFICE MANAGER)
- **Authorized official phone:** (386) 402-7827

## Contact information

- **Practice address:** 851 DUNLAWTON AVE STE 102, PORT ORANGE, FL 32127-4234
- **Practice address phone:** (386) 402-7827
- **Practice address fax:** (386) 410-5457
- **Mailing address:** 851 DUNLAWTON AVE STE 102, PORT ORANGE, FL 32127-4234
- **Mailing address phone:** (386) 402-7827
- **Mailing address fax:** (386) 410-5457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME117878 | FL | Yes |

## Other

- **Enumeration date:** 11/03/2017
- **Last updated:** 03/17/2018