Individual
SAMUEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 N CENTRAL AVE STE 212, KISSIMMEE, FL 34741-4440
(407) 259-8438
Mailing address
3327 JUJUBE DR, ORLANDO, FL 32810-2980
(407) 927-9810
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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