Provider Demographics
NPI:1639148877
Name:DAVILA-TORRES, ELSIE A (MD/)
Entity type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:A
Last Name:DAVILA-TORRES
Suffix:
Gender:F
Credentials:MD/
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W FORTUNE ST APT 1225
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3209
Mailing Address - Country:US
Mailing Address - Phone:786-863-2205
Mailing Address - Fax:813-984-8827
Practice Address - Street 1:5001 E BUSCH BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-5303
Practice Address - Country:US
Practice Address - Phone:813-984-8846
Practice Address - Fax:813-984-8827
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9489208000000X
FLME57590208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275177100Medicaid