Provider Demographics
NPI:1265699466
Name:DAVIDSON, HILA (MAC AP MMQ)
Entity type:Individual
Prefix:MRS
First Name:HILA
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MAC AP MMQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 N 40TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1938
Mailing Address - Country:US
Mailing Address - Phone:786-768-1999
Mailing Address - Fax:
Practice Address - Street 1:3390 N 40TH ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1938
Practice Address - Country:US
Practice Address - Phone:786-768-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor