Individual
TIMOTHY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
306 LAUREL OAKS WAY, JUPITER, FL 33458-8873
(561) 309-8124
Mailing address
306 LAUREL OAKS WAY, JUPITER, FL 33458-8873
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104027
FL
Other
Enumeration date
12/30/2008
Last updated
12/30/2008
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