Provider Demographics
NPI:1396036299
Name:DAVILA, YULAINE (LMT)
Entity Type:Individual
Prefix:
First Name:YULAINE
Middle Name:
Last Name:DAVILA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NW 72ND AVE APT 503
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5837
Mailing Address - Country:US
Mailing Address - Phone:305-267-4414
Mailing Address - Fax:
Practice Address - Street 1:525 NW 72ND AVE APT 503
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5837
Practice Address - Country:US
Practice Address - Phone:305-267-4414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA64406225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist