Individual provider Active NPI

Enrique Davila, MD

  • Hematology & Oncology Physician
  • Aventura, FL
National Provider Identifier
1750378709
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME31035 Issued in FL
Practice address
21150 Biscayne Blvd
Suite 206
Aventura, FL 33180-1226
Phone
(305) 384-6100
Fax
(305) 545-6687
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME31035 FL Primary

Addresses

Primary practice location

21150 Biscayne Blvd
Suite 206
Aventura, FL 33180-1226

Mailing address

1959 Secoffee St
Miami, FL 33133-3210
Phone (305) 856-8288

Other identifiers 1

IdentifierTypeStateIssuer
272190200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061117000205 FL Practitioner - Hematology/OncologyPractitioner - Medical OncologyPractitioner - Internal Medicine 2860490307 Practice locations: South Miami, FL
I20180627002499 TX Practitioner - Hematology/Oncology 2860490307 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Jun 13, 2018 Accepting new patients
Comprehensive Cancer Centers Inc Past Accepting new patients
Oncology & Hematology Associates of West Broward, P.a. PastSince Jan 7, 2024 Accepting new patients
Enrique Davila, P.a. Past Accepting new patients
Comprehensive Cancer Centers Inc Past Accepting new patients
Aventura Healthcare Specialists, LLC Hematology & Oncology Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1750378709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 SECOFFEE ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331333210",
            "telephone_number": "305-856-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21150 BISCAYNE BLVD",
            "address_2": "SUITE 206",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801226",
            "telephone_number": "305-384-6100",
            "fax_number": "305-545-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME31035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272190200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.