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Individual

DR. JOHN BERTRAND DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1307 ISABEL DR, SANIBEL, FL 33957-3511
(239) 470-1020
Mailing address
1307 ISABEL DR, SANIBEL, FL 33957-3511
(239) 470-1020

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
0039739
FL
207YS0123X
Facial Plastic Surgery Physician
Primary
MD.207761
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11986
BC/BS
FL
Enumeration date
01/08/2008
Last updated
08/13/2020
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