Organization
ELIZABETH DAQUILA MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEMA BURRILL (OFFICE MANAGER)
(386) 402-7827
Entity
Organization
Contact information
Practice address
851 DUNLAWTON AVE STE 102, PORT ORANGE, FL 32127-4234
(386) 402-7827
(386) 410-5457
Mailing address
851 DUNLAWTON AVE STE 102, PORT ORANGE, FL 32127-4234
(386) 402-7827
(386) 410-5457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME117878
FL
Other
Enumeration date
11/03/2017
Last updated
03/17/2018
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