Provider Demographics
NPI:1043293830
Name:MAYOR-DAVIES, JUDY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDY ANN
Middle Name:
Last Name:MAYOR-DAVIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 S APOLLO BLVD STE 406
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3185
Mailing Address - Country:US
Mailing Address - Phone:321-727-2990
Mailing Address - Fax:321-724-0455
Practice Address - Street 1:2501 W NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-3747
Practice Address - Country:US
Practice Address - Phone:321-723-9411
Practice Address - Fax:321-724-8749
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5946622OtherAETNA
FL42685OtherBLUE CROSS BLUE SHIELD
FL253481900Medicaid
FL3764544OtherAETNA
GAP00213337OtherRAILROAD MEDICARE
FL1639820004OtherCIGNA
FL269852OtherWELLCARE
FL1639820004OtherCIGNA
FL5946622OtherAETNA