Provider Demographics
NPI:1063611598
Name:DAVILA GARCIA, HUGO HERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:HUGO
Middle Name:HERNANDO
Last Name:DAVILA GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HUGO
Other - Middle Name:
Other - Last Name:DAVILA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:ATTN: CREDENTIALING DEPT
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:3730 7TH TER STE 101
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6556
Practice Address - Country:US
Practice Address - Phone:772-581-0528
Practice Address - Fax:844-829-3327
Is Sole Proprietor?:No
Enumeration Date:2007-07-14
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 104291208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009449200Medicaid
FLHP772XMedicare PIN