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General NPI Number Information
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NPI Number | 1174520266
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Entity Type | Individual
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Provider Name | JUDD PAUL DAVIS DC
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 7335 W SAND LAKE RD STE 125
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City | ORLANDO
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State | FL
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Zip | 32819-5539
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Country | US
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Telephone | 497-930-7132
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Fax |
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Provider Business Mailing Address
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Address Line | 1675 S FISKE BLVD APT M153
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2573
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Country | US
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Telephone | 914-821-7393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13154
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License Number State | FL
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