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General NPI Number Information
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NPI Number | 1407900277
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Entity Type | Individual
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Provider Name | EDITH DAVIS MD
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 1190 NW 95TH ST STE 401
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City | MIAMI
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State | FL
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Zip | 33150
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Country | US
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Telephone | 305-696-4400
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Fax | 305-757-5522
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Provider Business Mailing Address
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Address Line | PO BOX 681578
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City | MIAMI
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State | FL
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Zip | 33168-1578
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Country | US
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Telephone | 305-696-4400
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Fax | 305-696-6974
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME53312
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME53312
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License Number State | FL
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