MEDICARE: MR. NICHOLAS 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1639978703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS DAVIS

Provider Business Mailing Address
First Line	:	2692 GALE ROSE DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805
Country	:	US
Telephone Number	:	863-701-4326
Fax Number	:

Provider Business Practice Location Address
First Line	:	2692 GALE ROSE DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-8545
Country	:	US
Telephone Number	:	863-701-4326
Fax Number	:

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

Provider Enumeration Date	:	03/11/2025
Last Update Date	:	03/11/2025

Similar Medicare Providers

1427886167 — OLIVIA LUTHER RD, M.S
Practice Location Address:

10273 OAK BANK CV
LAKELAND, TN
38002-8545

Practice Phone: 901-389-0798
Practice Fax:

1417716465 — SAIF MEMON
Practice Location Address:

1324 LAKELAND HILLS BLVD
LAKELAND, FL
33805-4543

Practice Phone: 863-687-1100
Practice Fax:

1104752609 — JAMESLA H SMITH
Practice Location Address:

1711 FRUITWOOD DR
LAKELAND, FL
33805-2679

Practice Phone: 863-458-5447
Practice Fax:

1558050799 — MATTHEW MANSOUR
Practice Location Address:

1324 LAKELAND HILLS BLVD
LAKELAND, FL
33805-4543

Practice Phone: 863-687-1100
Practice Fax:

1851134415 — WHITNEY FILIPPONE
Practice Location Address:

3838 LAKELAND HILLS BLVD
LAKELAND, FL
33805-1980

Practice Phone: 863-660-6560
Practice Fax:

1336112747 — JOHN GERALD GALVEZ CANTO MD
Practice Location Address:

1600 LAKELAND HILLS BLVD
LAKELAND, FL
33805

Practice Phone: 863-680-7000
Practice Fax: 866-264-8519

Directions to “ MR. NICHOLAS DAVIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.