Individual
JOHN THOMAS DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 36TH ST, STE 1H, VERO BEACH, FL 32960-4898
(772) 563-0146
(772) 770-5817
Mailing address
1300 36TH ST, STE 1H, VERO BEACH, FL 32960-4898
(772) 563-0146
(772) 770-5817
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044564900
—
FL
Enumeration date
06/01/2005
Last updated
07/08/2007
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