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NPI Code Detail

MEDICARE: EILEEN C DAVIES P.T.

MEDICARE: EILEEN C DAVIES P.T.
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
12251P0200XPediatric Physical TherapistPT8104FL
2225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750373114
Entity Type Code : Individual
Provider Name (Legal Business Name) : EILEEN C DAVIES P.T.
Provider Business Mailing Address
First Line : 249 ORANGE AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32259-4215
Country : US
Telephone Number : 904-230-7148
Fax Number : 904-230-7148
Provider Business Practice Location Address
First Line : 901 CLARK ST
Second Line :
City : OVIEDO
State : FL
Zip : 32765-7378
Country : US
Telephone Number : 407-359-5693
Fax Number : 407-792-5693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2005
Last Update Date : 07/06/2021

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