Individual
DR. STACY ANN MARIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1334 VALENTINE ST, MELBOURNE, FL 32901-3128
(321) 676-1870
(321) 768-2172
Mailing address
95 BULLDOG BLVD, SUITE 202, MELBOURNE, FL 32901-3332
(321) 727-2990
(321) 724-0455
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
ME105521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
FLORIDA DOCTORS INS/MALPRACTICE CARRIER
FL
05
—
003136400
—
FL
01
—
1082606
CAREPLUS
FL
01
—
149KA
BCBS
FL
01
—
3666528
CIGNA
FL
01
—
581795
WELLCARE
FL
01
—
59-3169815
BEECHSTREET
FL
01
—
6573631
AETNA HMO
FL
01
—
9787626
AETNA PPO
FL
01
—
PRO11849
QUALITY HEALTH PLAN
FL
Enumeration date
07/25/2007
Last updated
03/06/2012
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