Organization
DAVIS DIAGNOSTICS LLC
Active
Other names
Daytona Horizon MRI LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF DAVIS (OWNER)
(386) 677-8680
Entity
Organization
Contact information
Practice address
290 CLYDE MORRIS BLVD, STE C1, ORMOND BEACH, FL 32174-8204
(386) 677-8680
(386) 677-6895
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC1817-EXEMPT
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V2694
BCBS PROV #
FL
Enumeration date
05/27/2005
Last updated
08/22/2020
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