Individual
MISS SHAWAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 BOWDEN ROAD UNIT 1104, JACKSONVILLE, FL 32216
(904) 415-7665
Mailing address
6700 BOWDEN RD UNIT 1104, JACKSONVILLE, FL 32216-3672
(904) 415-7665
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
FL
343900000X
Non-emergency Medical Transport (VAN)
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813927678
—
FL
Enumeration date
02/08/2022
Last updated
02/08/2022
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