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Individual

JOSE A AVILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-8507
Mailing address
10940 STATE ROAD 70 E STE 103, LAKEWOOD RANCH, FL 34202-8401
(941) 243-3088
(941) 243-3085

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0058034
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14915
BLUE CROSS BLUE SHIELD
FL
05
371176500
FL
Enumeration date
12/01/2005
Last updated
12/03/2025
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