Provider Demographics
NPI:1760463269
Name:BROWN, DAVILA, KHAN, MAZA, RUIZ & WHIRLEY-DIAZ, M.D.'S, P.A.
Entity Type:Organization
Organization Name:BROWN, DAVILA, KHAN, MAZA, RUIZ & WHIRLEY-DIAZ, M.D.'S, P.A.
Other - Org Name:DOCTORS ANESTHESIA ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-448-9018
Mailing Address - Street 1:7600 S RED RD STE 229
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5408
Mailing Address - Country:US
Mailing Address - Phone:305-448-9018
Mailing Address - Fax:305-448-1895
Practice Address - Street 1:5000 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:305-448-9018
Practice Address - Fax:305-448-1895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00886OtherB/C & B/S OF FL
FL056947000Medicaid
FL056947000Medicaid