Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS15488 | FL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | OS15488 | FL |
NPI | 1235419193 |
---|---|
Provider Name | Dr. Sophia Pereira Davis |
First Address | Orlando, FL 32806-4476 |
Second Address | Orlando, FL 32806-4476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2011 |
Last Update Date | 10/06/2020 |