=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164983912
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXANDER R DAVIS DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2019
-----------------------------------------------------
Last Update Date | 07/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10820 STATE ROAD 54 STE 201
-----------------------------------------------------
City | TRINITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34655-2291
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-846-7131
-----------------------------------------------------
Fax | 727-846-7132
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3001 EXECUTIVE DR STE 130
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33762-5323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-347-0005
-----------------------------------------------------
Fax | 727-541-6558
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | OS18362
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------