DAVILA MEDICAL CENTER INC

NPI 1902113939, organization, Miami, FL, General Practice

Evidence tier

adjudicated in a public enforcement record

Adjudicated (sentenced) per a Department of Justice release dated October 11, 2024.
No Medicaid payments in the last 12 observed months.

Public enforcement record: Miami Man Sentenced to Over 5 Years in Prison and Ordered to Pay Over $3.8 Million for Fraudulently Billing Medicaid for Psychosocial Rehabilitation Services

score 90 of 100, rank 649, $0 at stake

Public list actions

Medicare revocation effective October 22, 2024, barred from re-enrolling until June 5, 2030

424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Part B Supplier - Clinic/Group Practice, FL

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	DAVILA MEDICAL CENTER INC
Type	Organization
Status	Active
NPI issued	September 13, 2010, last updated June 15, 2023
Practice location	4315 NW 7TH ST STE 47, Miami, FL 33126-3561, 305-441-2760
Authorized official	JOSE DAVILA (President)
Specialties	Family Medicine (207Q00000X) Clinic/Center, Primary Care (261QP2300X, license HCC8852 FL) General Practice (208D00000X, primary)

In this area

256 providers in Miami-Dade County, FL carry an indicator in the public record, with $454.5M at stake between them. The most common is more hours than a day holds, on 203 of them, followed by part of a provider network on 44. 5 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	ALAN SWARTZ Miami, FL, ranked 419	$452	Listed on the Medicare revocation list since January 11, 2021. Medicaid still paid claims in 1 later month, $452 in total.
1	ROSALVA ZEGARRA Hialeah, FL, ranked 424	$302	Listed on the Medicare revocation list since December 1, 2020. Medicaid still paid claims in 1 later month, $302 in total.
1	LARKIN BEHAVIOR HEALTH INC Hialeah Gardens, FL, ranked 501	$0	Adjudicated (sentenced) per a Department of Justice release dated October 11, 2024. No Medicaid payments in the last 12 observed months.
1	ABRH CARE INC Miami, FL, ranked 507	$0	Adjudicated (sentenced, charged) per an HHS-OIG enforcement record and a Department of Justice release dated May 22, 2026. No Medicaid payments in the last 12 observed months.
1	NEW BEHAVIOR HEALTH DIRECTION INC Miami, FL, ranked 683	$0	Adjudicated (sentenced) per a Department of Justice release dated October 11, 2024. No Medicaid payments in the last 12 observed months.
2	MARIA MACHADO Miami, FL, ranked 691	$4.0M	Billed more hands-on hours than a day holds in 9 months, peaking at 25.9 hours per day across 10 billing organizations. Medicaid dollars per patient on code 97110 ($428 per patient-month) sit in the top 5% of every provider billing that code.
2	MASSIEL MERLO-GOMEZ Miami, FL, ranked 740	$387K	Billed more hands-on hours than a day holds in 1 month, peaking at 14.2 hours per day across 4 billing organizations.
3	PRIMARY MEDICAL STAFFING, INC. Miami Lakes, FL, ranked 756	$17.5M	Part of provider network D1-00129, ranked 129 nationally. Medicaid dollars per patient on code S9123 ($12257 per patient-month) sit in the top 5% of every provider billing that code.

All 256 in FL

Recent enforcement in FL

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJPleaded guiltyAug 14, 2026

Ocala Mental Health Counselor Pleads Guilty to Aggravated Identity Theft and Wire Fraud

Forsythe used the names and insurance policy information of 22 individuals without their consent to bill two health insurance companies for counseling services she had not provided.

DOJConvictedAug 12, 2026

Cuban National Convicted of Unlawfully Obtaining US Citizenship After Concealing Healthcare Fraud Scheme

Rodriguez concealed on her naturalization application her participation in a seven-year healthcare fraud conspiracy that resulted in approximately $4.6 million in fraudulent healthcare claims.

DOJCivil settlementAug 3, 2026

Medicare Advantage Provider Complete Health to Pay $14,100,000 to Settle False Claims Act Suit

Complete Health caused the submission of diagnosis codes within HCC 55 and HCC 59 that were not clinically valid, not supported by medical records, and/or not considered in the beneficiary's care, increasing Medicare Advantage risk-adjusted payments from which it received a percentage.

DOJCivil settlementJul 31, 2026

Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds

Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses, with one practice receiving remuneration from a third-party testing company to refer patients for the tests.

DOJCivil settlementJul 31, 2026

Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds

Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses and, as to Floral Park Ophthalmology, resulting from remuneration paid by a third-party testing company to induce referrals.

Referral packet

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