Provider Demographics
NPI:1689772568
Name:DAVIS, MAUREEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 S DIXIE HWY
Mailing Address - Street 2:STE 206
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3074
Mailing Address - Country:US
Mailing Address - Phone:305-668-9545
Mailing Address - Fax:305-668-9541
Practice Address - Street 1:1001 N FEDERAL HWY
Practice Address - Street 2:STE 103
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2400
Practice Address - Country:US
Practice Address - Phone:954-241-0145
Practice Address - Fax:954-987-3097
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHOOO7674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381425400Medicaid
FL54025OtherBLUE CROSS BLUE SHIELD
FL465307OtherTUFTS PHCS
FLP00089346OtherRAILROAD MEDICARE
FLP00089346OtherRAILROAD MEDICARE