Individual
IFE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPECIALIST
Contact information
Practice address
1834 49TH ST S, GULFPORT, FL 33707-4387
(727) 328-2623
(727) 800-5007
Mailing address
1834 49TH ST S, GULFPORT, FL 33707-4387
(727) 328-2623
(727) 800-5007
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
CL0239124
FL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CL0239124
FL
335E00000X
Prosthetic/Orthotic Supplier
CL0239124
FL
Other
Enumeration date
12/03/2014
Last updated
08/14/2023
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