MEDICARE: SHRIKA SHONTA DAVIS FNP

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	363LF0000X	Family Nurse Practitioner	9312973	FL

General Provider Information

NPI Number	:	1821526393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHRIKA SHONTA DAVIS FNP

Provider Business Mailing Address
First Line	:	5112 N HABANA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5112 N HABANA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6873
Country	:	US
Telephone Number	:	813-374-2406
Fax Number	:

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

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	04/26/2019

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