Provider Demographics
NPI:1255959995
Name:DAVIS, FELECIA A
Entity type:Individual
Prefix:
First Name:FELECIA
Middle Name:A
Last Name: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 1:9508 WINDERMERE PARK CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-2587
Mailing Address - Country:US
Mailing Address - Phone:352-426-2044
Mailing Address - Fax:
Practice Address - Street 1:9508 WINDERMERE PARK CIR APT 201
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-2587
Practice Address - Country:US
Practice Address - Phone:352-426-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health