Provider Demographics
NPI:1831437524
Name:DAVIS, CINDY J
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:J
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:11400 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5310
Mailing Address - Country:US
Mailing Address - Phone:727-792-8105
Mailing Address - Fax:727-848-3656
Practice Address - Street 1:11400 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5310
Practice Address - Country:US
Practice Address - Phone:727-792-8105
Practice Address - Fax:727-848-3656
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS0029277OtherPHARMACIST