MEDICARE: MICHAEL DAVIDSON APRN-FNP-BC

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	9241690	FL

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	:	1851921928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DAVIDSON APRN-FNP-BC

Provider Business Mailing Address
First Line	:	3047 JOAN CT
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4670
Country	:	US
Telephone Number	:	727-599-7301
Fax Number	:

Provider Business Practice Location Address
First Line	:	5414 TOWN N COUNTRY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4120
Country	:	US
Telephone Number	:	813-886-4395
Fax Number	:

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

Provider Enumeration Date	:	01/17/2020
Last Update Date	:	01/17/2020

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