Provider Demographics
NPI:1487956702
Name:DAVILA-SOLA, ROSEMARY (DPM)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:DAVILA-SOLA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9617 SW 74TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3208
Mailing Address - Country:US
Mailing Address - Phone:305-984-1154
Mailing Address - Fax:
Practice Address - Street 1:9617 SW 74TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3208
Practice Address - Country:US
Practice Address - Phone:305-984-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-0001666213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003619900Medicaid