Individual provider Active NPI

Stacee Bonita Davila, DPT

  • Orthopedic Physical Therapist
  • Bonita Springs, FL
National Provider Identifier
1417132374
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT23806 Issued in FL
Practice address
24820 Burnt Pine Dr
Ste 4
Bonita Springs, FL 34134-2028
Phone
(239) 947-4184
Fax
(239) 947-4171
NPI assigned
Jan 9, 2008
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT23806 FL Primary

Addresses

Primary practice location

24820 Burnt Pine Dr
Ste 4
Bonita Springs, FL 34134-2028

Mailing address

24820 Burnt Pine Dr
Ste 4
Bonita Springs, FL 34134-2028
Phone (239) 947-4184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT23806FLMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fyzbiz, LLC PastSince Aug 1, 2022 Accepting new patients
Douglass Orthopedic & Spine Rehabilitation, Inc. PastSince Jul 1, 2001 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1417132374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24820 BURNT PINE DR",
            "address_2": "STE 4",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341342028",
            "telephone_number": "239-947-4184",
            "fax_number": "239-947-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24820 BURNT PINE DR",
            "address_2": "STE 4",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341342028",
            "telephone_number": "239-947-4184",
            "fax_number": "239-947-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "STACEE",
        "middle_name": "BONITA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT23806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.