Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 43095 | FL |
Y | 101YS0200X | School Counselor | 744979 | FL |
NPI | 1184851370 |
---|---|
Provider Name | Dr. Rafael Angel Davila III |
First Address | Orlando, FL 32828-6178 |
Second Address | Orlando, FL 32828-6178 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 16/06/2009 |