MEDICARE: PADRICA DAVIS

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
1	372500000X	Chore Provider	002106300	FL
2	372600000X	Adult Companion	002106300	FL
3	376J00000X	Homemaker	002106300	FL
4	374U00000X	Home Health Aide	002106300	FL

General Provider Information

NPI Number	:	1356074199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PADRICA DAVIS

Provider Business Mailing Address
First Line	:	4825 33RD AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-1229
Country	:	US
Telephone Number	:	772-646-5350
Fax Number	:

Provider Business Practice Location Address
First Line	:	4825 33RD AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-1229
Country	:	US
Telephone Number	:	772-646-5350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	07/08/2022

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Directions to “ PADRICA DAVIS ” Practice Location

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