Provider Demographics
NPI:1306833488
Name:DAVIS, PAMELA GAY (ARNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:GAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 N KENDALL DR
Mailing Address - Street 2:STE. 300E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2148
Mailing Address - Country:US
Mailing Address - Phone:305-595-2141
Mailing Address - Fax:305-279-7778
Practice Address - Street 1:8940 N KENDALL DR
Practice Address - Street 2:STE. 300E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2148
Practice Address - Country:US
Practice Address - Phone:305-595-2141
Practice Address - Fax:305-279-7778
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9176235363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4842Medicare ID - Type Unspecified
S43364Medicare UPIN