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General NPI Number Information
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NPI Number | 1255010310
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Entity Type | Organization
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Legal Business Name | DAVIS FAMILY HEALTH AND WELLNESS
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 2151 45TH ST STE 102
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2006
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Country | US
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Telephone | 561-537-9012
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 45TH ST STE 102
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2006
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Country | US
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Telephone | 561-537-9012
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Fax |
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Authorized Official
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Title or Position | VP
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Name | LILLIAN DAVIS
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Credential | NURSE PRACTITIONER
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Telephone | 561-679-3150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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