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Individual

SUSAN DAVILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1150 N 35TH AVE, #400, HOLLYWOOD, FL 33021-5424
(954) 963-6363
Mailing address
PO BOX 452315, SUNRISE, FL 33345-2315

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME61862
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14964
BCBS OF FL
FL
Enumeration date
01/17/2006
Last updated
10/09/2007
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