Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MD202689 | LA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME 116561 | FL |
NPI | 1427259076 |
---|---|
Provider Name | Davida Packer |
First Address | West Palm Beach, FL 33407-2413 |
Second Address | West Palm Beach, FL 33407-2413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 08/05/2015 |