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NPI Code Detail

MEDICARE: DR. DAVIDSON ANTENOR M.D

MEDICARE:  DR. DAVIDSON  ANTENOR  M.D
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
1363LF0000XFamily Nurse PractitionerAPRN11040085FL

General Provider Information

NPI Number : 1720527815
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVIDSON ANTENOR M.D
Provider Business Mailing Address
First Line : 1063 S HIAWASSEE RD APT 1614
Second Line :
City : ORLANDO
State : FL
Zip : 32835-1827
Country : US
Telephone Number : 321-444-5538
Fax Number :
Provider Business Practice Location Address
First Line : 453 N KIRKMAN RD
Second Line : STE 203
City : ORLANDO
State : FL
Zip : 32811-1109
Country : US
Telephone Number : 407-914-2325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2017
Last Update Date : 02/13/2026

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Directions to “ DR. DAVIDSON ANTENOR M.D” Practice Location

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