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General NPI Number Information
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NPI Number | 1922265875
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Entity Type | Individual
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Provider Name | CHRISTINA E DAVIS PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 1150 N 35TH AVE SUITE 540
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5424
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Country | US
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Telephone | 954-966-8559
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Fax | 954-966-1156
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Provider Business Mailing Address
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Address Line | 1150 N 35TH AVE SUITE 540
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5424
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Country | US
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Telephone | 954-966-8559
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Fax | 954-966-1156
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | AP2459
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9105073
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License Number State | FL
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