Provider Demographics
NPI:1013117449
Name:DAVIS, JOSHUA ADAM (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ADAM
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 1:7431 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 52
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3512
Mailing Address - Country:US
Mailing Address - Phone:561-638-7455
Mailing Address - Fax:561-638-7873
Practice Address - Street 1:7431 W ATLANTIC AVE
Practice Address - Street 2:SUITE 52
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3512
Practice Address - Country:US
Practice Address - Phone:561-638-7455
Practice Address - Fax:561-638-7873
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCZ519ZOtherMEDICARE PTAN
FLY03UROtherBCBS