Individual
ELICENDA SOTO DAVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8180 NW 36TH ST STE 209, DORAL, FL 33166-6653
(786) 334-6946
(786) 313-3079
Mailing address
8180 NW 36TH ST STE 209, DORAL, FL 33166-6653
(786) 334-6946
(786) 313-3079
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM102831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CBHCM102831
FCB
FL
Enumeration date
12/15/2021
Last updated
12/15/2021
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