Individual
AMY R. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4202 E FOWLER AVE, PCD1017, TAMPA, FL 33620-8000
(813) 974-9844
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 6897
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003630000
—
FL
01
—
S00SM
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/14/2011
Last updated
05/19/2014
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