Healthcare Provider Details

I. General information

NPI: 1184540494
Provider Name (Legal Business Name): ALIYAH DAVIS DSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11510 PARAGRAPH RD
ORLANDO FL
32832-6774
US

IV. Provider business mailing address

11510 PARAGRAPH RD
ORLANDO FL
32832-6774
US

V. Phone/Fax

Practice location:
  • Phone: 863-558-1123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04506
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: