Healthcare Provider Details

I. General information

NPI: 1922939115
Provider Name (Legal Business Name): CHRISTINA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 SW 141ST TER
PALMETTO BAY FL
33158-1238
US

IV. Provider business mailing address

7450 SW 141ST TER
PALMETTO BAY FL
33158-1238
US

V. Phone/Fax

Practice location:
  • Phone: 305-439-6877
  • Fax:
Mailing address:
  • Phone: 305-439-6877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN9437465
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: