Provider Demographics
NPI:1780494542
Name:DAVIS, JULIANA AMORIM
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:AMORIM
Last Name:DAVIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15932 E HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488-5144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15932 E HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-5144
Practice Address - Country:US
Practice Address - Phone:941-204-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9119803363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant