Provider Demographics
NPI:1336142678
Name:DAVIS, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:483 N SEMORAN BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3800
Mailing Address - Country:US
Mailing Address - Phone:407-645-1847
Mailing Address - Fax:321-274-0246
Practice Address - Street 1:483 N SEMORAN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3800
Practice Address - Country:US
Practice Address - Phone:407-645-1847
Practice Address - Fax:321-274-0246
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77920207RC0000X, 207RC0001X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL241017OtherAMERIGROUP MCD PROV ID #
FL8076595OtherCIGNA PROV ID #
FL20171632OtherUNITED H'CARE PROV ID #
FL46588OtherBCBS OF FL PROV ID #
FL1742603OtherFIRST HEALTH PROV ID #
FL266294900Medicaid
FL2298544OtherAETNA PROV ID
FL17621OtherFHHS PROV ID #
FLP00171877OtherRAILROAD MEDICARE
FL1742603OtherFIRST HEALTH PROV ID #
FL20171632OtherUNITED H'CARE PROV ID #
FL8076595OtherCIGNA PROV ID #