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NPI Code Detail

MEDICARE: MARY L DAVIS APRN

MEDICARE: MARY L DAVIS APRN
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
1146L00000XParamedicPMD16083FL
2163W00000XRegistered NurseRN2835352FL
3363L00000XNurse PractitionerAPRN2835352FL
4363LA2200XAdult Health Nurse PractitionerARNP2835352FL
5363LC1500XCommunity Health Nurse PractitionerAPRN2835352FL
6364SG0600XGerontology Clinical Nurse SpecialistARNP2835352FL
7363LG0600XGerontology Nurse PractitionerAPRN2835352FL

General Provider Information

NPI Number : 1699187591
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY L DAVIS APRN
Provider Business Mailing Address
First Line : 831 SIMPSON RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-5328
Country : US
Telephone Number : 407-483-5757
Fax Number : 855-342-2122
Provider Business Practice Location Address
First Line : 831 SIMPSON RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-5328
Country : US
Telephone Number : 407-483-5757
Fax Number : 855-342-2122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2014
Last Update Date : 05/14/2025

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