Provider Demographics
NPI:1417437559
Name:FLOWERS-DAVIS, MARVET A
Entity Type:Individual
Prefix:
First Name:MARVET
Middle Name:A
Last Name:FLOWERS-DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 STARLITE LN
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5653
Mailing Address - Country:US
Mailing Address - Phone:941-235-8770
Mailing Address - Fax:941-235-8770
Practice Address - Street 1:2532 STARLITE LN
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5653
Practice Address - Country:US
Practice Address - Phone:941-235-8770
Practice Address - Fax:941-235-8770
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL301359376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide