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General NPI Number Information
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NPI Number | 1205188562
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Entity Type | Individual
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Provider Name | GERIANNE DAVENPORT
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Gender | Female
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 02/02/2014
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Provider Practice Location Address
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Address Line | 235 CITRUS TOWER BLVD STE 106
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City | CLERMONT
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State | FL
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Zip | 34711-2711
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Country | US
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Telephone | 352-243-1212
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Fax | 352-243-6474
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Provider Business Mailing Address
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Address Line | 3210 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5243
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Country | US
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Telephone | 352-343-4488
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Fax | 352-343-7722
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS2574
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License Number State | FL
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