MEDICARE: CHEYANNE DAVIDSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	235Z00000X	Speech-Language Pathologist	SZ9487	FL
3	235Z00000X	Speech-Language Pathologist	18994

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144854308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYANNE DAVIDSON

Provider Business Mailing Address
First Line	:	6401 S WEST SHORE BLVD APT 215
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-1384
Country	:	US
Telephone Number	:	717-475-4406
Fax Number	:

Provider Business Practice Location Address
First Line	:	6401 S WEST SHORE BLVD APT 215
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-1384
Country	:	US
Telephone Number	:	717-475-4406
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	07/14/2022

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Directions to “ CHEYANNE DAVIDSON ” Practice Location

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