Provider Demographics
NPI:1265540876
Name:DAVIS, AMY SUMMER (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUMMER
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 SW 116 PLACE
Mailing Address - Street 2:UNIT A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1740
Mailing Address - Country:US
Mailing Address - Phone:305-271-4775
Mailing Address - Fax:
Practice Address - Street 1:1500 MONZA AVE SUITE 350
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3005
Practice Address - Country:US
Practice Address - Phone:305-740-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9752ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER