Individual
SHANTORIA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106 W JERSEY AVE, BRANDON, FL 33510-3130
(904) 888-4019
Mailing address
106 W JERSEY AVE, BRANDON, FL 33510-3130
(904) 888-4019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
D120787008370
FL
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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