Provider Demographics
NPI:1942934005
Name:GONZALEZ DAVILA, ABELSAIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ABELSAIN
Middle Name:
Last Name:GONZALEZ DAVILA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ABELSAIN
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:760 BARNES BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5314
Mailing Address - Country:US
Mailing Address - Phone:321-735-8102
Mailing Address - Fax:
Practice Address - Street 1:760 BARNES BLVD # 101-102
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5423
Practice Address - Country:US
Practice Address - Phone:321-735-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14147OtherCHIROPRACTIC PHYSICIAN LICENSE