Individual
LATIVIA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
424 NW 179TH ST, MIAMI GARDENS, FL 33169-4908
(786) 273-0621
Mailing address
424 NW 179TH ST, MIAMI GARDENS, FL 33169-4908
(786) 273-0621
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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