Healthcare Provider Details

I. General information

NPI: 1114717451
Provider Name (Legal Business Name): GABRIELA DAVIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

IV. Provider business mailing address

689 E ALTAMONTE DR
ALTAMONTE SPRINGS FL
32701-4801
US

V. Phone/Fax

Practice location:
  • Phone: 407-894-4474
  • Fax:
Mailing address:
  • Phone: 407-767-7262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11039394
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: