MEDICARE: AARON 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	363LF0000X	Family Nurse Practitioner	RN9547037	FL

General Provider Information

NPI Number	:	1710833934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON DAVIS

Provider Business Mailing Address
First Line	:	640 CHERRY ELM DR
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-0135
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 CHERRY ELM DR
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-0135
Country	:	US
Telephone Number	:	808-554-1748
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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