Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME64358 | FL |
NPI | 1346275443 |
---|---|
Provider Name | Dr. Richard Davis |
First Address | Weston, FL 33327-1427 |
Second Address | Miramar, FL 33029-5593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 19/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3734731-00 | (05) | FL |
F31375 | (02) | FL |