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Individual

MRS. GEORGIA D DAVAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP-BC

Contact information

Practice address
14271 METROPOLIS AVE, SUITE A, FORT MYERS, FL 33912-4302
(239) 939-7777
(239) 936-0036
Mailing address
5651 LOCHNESS CT, NORTH FORT MYERS, FL 33903-4928
(239) 997-7019

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1070882
FL

Other

Enumeration date
11/25/2008
Last updated
11/25/2008
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