Provider Demographics
NPI:1770353039
Name:DAVIS, QUASHEKA
Entity type:Individual
Prefix:
First Name:QUASHEKA
Middle Name:
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 1:2850 34TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-3635
Mailing Address - Country:US
Mailing Address - Phone:727-396-2502
Mailing Address - Fax:
Practice Address - Street 1:501 116TH AVE N APT 213
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-2723
Practice Address - Country:US
Practice Address - Phone:727-396-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health