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General NPI Number Information
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NPI Number | 1497184543
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Entity Type | Individual
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Provider Name | DANIELLA DAVIS PHARM D
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Gender | Female
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 10855 S US HIGHWAY 1 WALMART PHARMACY
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-6410
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Country | US
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Telephone | 772-335-1557
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Fax | 772-335-1559
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Provider Business Mailing Address
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Address Line | 10855 S US HIGHWAY 1 WALMART PHARMACY
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-6410
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Country | US
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Telephone | 772-335-1557
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Fax | 772-335-1559
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS41053
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH25832
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License Number State | MA
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