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NPI Code Detail

MEDICARE: DR. VICTOR DAVIS JR.

MEDICARE: DR. VICTOR DAVIS JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy PharmacistPS47803FL

General Provider Information

NPI Number : 1275803165
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VICTOR DAVIS JR.
Provider Business Mailing Address
First Line : 11010 SW 165TH TER
Second Line :
City : MIAMI
State : FL
Zip : 33157-2858
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1860 E FOWLER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-5511
Country : US
Telephone Number : 813-977-0651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2012
Last Update Date : 01/09/2012

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