Provider Demographics
NPI:1912201252
Name:DAVIS, MAURICE DEMPSEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:DEMPSEY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 S LAKE DASHA DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3014
Mailing Address - Country:US
Mailing Address - Phone:612-327-5911
Mailing Address - Fax:
Practice Address - Street 1:8910 S LAKE DASHA DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3014
Practice Address - Country:US
Practice Address - Phone:612-327-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL242892251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic