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General NPI Number Information
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NPI Number | 1700963188
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Entity Type | Organization
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Legal Business Name | MEIVIS HEALTH LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 7232 W SAND LAKE RD STE 201
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City | ORLANDO
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State | FL
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Zip | 32819-5260
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Country | US
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Telephone | 407-351-5660
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Fax | 407-363-6707
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Provider Business Mailing Address
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Address Line | 7232 W SAND LAKE RD STE 201
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City | ORLANDO
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State | FL
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Zip | 32819-5260
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Country | US
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Telephone | 407-351-5660
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Fax | 407-363-6707
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEIF E DAVIS
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Credential | PSYD
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Telephone | 407-351-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6304
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License Number State | FL
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