Healthcare Provider Details

I. General information

NPI: 1033151774
Provider Name (Legal Business Name): JANICE R WALKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE R BORROWS

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12555 ORANGE DR STE 227
DAVIE FL
33330-4304
US

IV. Provider business mailing address

12555 ORANGE DR STE 227
DAVIE FL
33330-4304
US

V. Phone/Fax

Practice location:
  • Phone: 954-862-1706
  • Fax: 954-405-8915
Mailing address:
  • Phone: 954-862-1706
  • Fax: 954-405-8915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME105928
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: