Provider Demographics
NPI:1356534994
Name:DAVIS, CEDRIC EMDEN II (MD)
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:EMDEN
Last Name:DAVIS
Suffix:II
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 W OAKLAND PARK BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7261
Mailing Address - Country:US
Mailing Address - Phone:954-900-4381
Mailing Address - Fax:954-916-7952
Practice Address - Street 1:4850 W OAKLAND PARK BLVD STE 209
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7261
Practice Address - Country:US
Practice Address - Phone:954-900-4381
Practice Address - Fax:954-916-7952
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25854207Q00000X
IL036145261208M00000X
FLME108693208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist