Provider Demographics
NPI:1316537343
Name:DAVIS, GEORGE III (APRN)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:DAVIS
Suffix:III
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 HAWBUCK ST
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5307
Mailing Address - Country:US
Mailing Address - Phone:727-359-1669
Mailing Address - Fax:
Practice Address - Street 1:5290 APPLEGATE DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4507
Practice Address - Country:US
Practice Address - Phone:352-686-3101
Practice Address - Fax:352-688-8713
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily