Healthcare Provider Details

I. General information

NPI: 1144936584
Provider Name (Legal Business Name): DAVID MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 WILDMEADOW RUN
WINTER PARK FL
32792-3036
US

IV. Provider business mailing address

1155 WILDMEADOW RUN
WINTER PARK FL
32792-3036
US

V. Phone/Fax

Practice location:
  • Phone: 786-545-6132
  • Fax:
Mailing address:
  • Phone: 786-545-6132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QG0250X
TaxonomyGenetics Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARGARITA N. DAVID
Title or Position: PRESIDENT
Credential: MD
Phone: 786-545-6132