Elizabeth Daquila MD, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME117878 Issued in FL

Legal business name

ELIZABETH DAQUILA MD, LLC

Practice address

851 Dunlawton Ave Ste 102
Port Orange, FL 32127-4234

Phone

(386) 402-7827

Fax

(386) 410-5457

NPI assigned

Nov 3, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shema Burrill

Title

Office Manager

Phone

(386) 402-7827

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth M Daquila, M.D.

  • Family Medicine Physician
  • Rocky Mount, NC
  • NPI 1952637530

  FL

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1154833887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 DUNLAWTON AVE STE 102",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274234",
            "telephone_number": "386-402-7827",
            "fax_number": "386-410-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 DUNLAWTON AVE STE 102",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274234",
            "telephone_number": "386-402-7827",
            "fax_number": "386-410-5457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 N Causeway Ste C",
            "address_purpose": "LOCATION",
            "city": "New Smyrna",
            "state": "FL",
            "postal_code": "321695300",
            "country_code": "US",
            "telephone_number": "386-424-8440",
            "fax_number": "386-426-8839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "161 N Causeway Ste C",
            "address_purpose": "LOCATION",
            "city": "New Smyrna",
            "state": "FL",
            "postal_code": "321695300",
            "country_code": "US",
            "telephone_number": "386-424-8440",
            "fax_number": "386-426-8839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELIZABETH DAQUILA MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BURRILL",
        "authorized_official_first_name": "SHEMA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-402-7827"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME117878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devaughn Edwards, RBT
• Lori Katherine Ehmann, OTR
• Valerie Eitel
• El Kebeer
• Elite Spine LLC
• Elizabeth Lee OD PA
• Sara Elliott, LMHC
• Amy Louise Ellis, PT
• Aaron Ellman
• Ashraf S Elsakr, M.D.

• Family Medicine Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.