Healthcare Provider Details

I. General information

NPI: 1699144691
Provider Name (Legal Business Name): MARICRUZ DAVIS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARICRUZ HUBBARMS APRN, FNP-C

II. Dates (important events)

Enumeration Date: 09/20/2015
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3539 POSEIDON WAY
INDIALANTIC FL
32903-1843
US

IV. Provider business mailing address

3539 POSEIDON WAY
INDIALANTIC FL
32903-1843
US

V. Phone/Fax

Practice location:
  • Phone: 703-867-8343
  • Fax:
Mailing address:
  • Phone: 703-867-8343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95002592
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11019831
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1699144691
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number240270
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number59189
License Number StateID
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172360
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: