Provider Demographics
NPI:1912462441
Name:DAVIS SPINE AND ORTHOPAEDICS LLC
Entity Type:Organization
Organization Name:DAVIS SPINE AND ORTHOPAEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:813-994-2225
Mailing Address - Street 1:2629 WINDGUARD CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7355
Mailing Address - Country:US
Mailing Address - Phone:813-994-2225
Mailing Address - Fax:
Practice Address - Street 1:2629 WINDGUARD CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7355
Practice Address - Country:US
Practice Address - Phone:813-994-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty