Healthcare Provider Details

I. General information

NPI: 1578754875
Provider Name (Legal Business Name): JOSEPH BARTLETT DAVIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 AVENUE A SE
WINTER HAVEN FL
33880-6301
US

IV. Provider business mailing address

8340 VIA VITTORIA WAY
ORLANDO FL
32819-5423
US

V. Phone/Fax

Practice location:
  • Phone: 407-748-6461
  • Fax: 917-451-6327
Mailing address:
  • Phone: 407-748-6461
  • Fax: 917-451-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberOS19325
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number255869
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: