Healthcare Provider Details

I. General information

NPI: 1902143621
Provider Name (Legal Business Name): DAVISON HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2013
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7532 CLEARVIEW DR
TAMPA FL
33634-2930
US

IV. Provider business mailing address

7532 CLEARVIEW DR
TAMPA FL
33634-2930
US

V. Phone/Fax

Practice location:
  • Phone: 813-789-1735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberME 114790
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberME 114790
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberME 114790
License Number StateFL

VIII. Authorized Official

Name: DR. JAMILA DAVISON
Title or Position: OWNER
Credential:
Phone: 813-789-1735