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NPI Code Detail

MEDICARE: DEMIYA DAVIS

MEDICARE:   DEMIYA  DAVIS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639943020
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEMIYA DAVIS
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18110 NW 9TH AVE
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-4216
Country : US
Telephone Number : 786-953-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2023
Last Update Date : 11/07/2023

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Directions to “ DEMIYA DAVIS ” Practice Location

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