Organization
STEPHEN P. DAVIS, PH.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN P. DAVIS PH.D. (PRESIDENT)
(772) 398-1003
Entity
Organization
Contact information
Practice address
2400 SE MIDPORT RD, SUITE 211, PORT ST LUCIE, FL 34952-4823
(772) 398-1003
(772) 398-1772
Mailing address
2400 SE MIDPORT RD, SUITE 211, PORT ST LUCIE, FL 34952-4823
(772) 398-1003
(772) 398-1772
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 5785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10745971
AETNA
FL
01
—
125175
VALUE OPTIONS
FL
01
—
82322
CIGNA
FL
01
—
IP029180
MAGELLAN
FL
Enumeration date
07/11/2006
Last updated
08/22/2020
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