Provider Demographics
NPI:1932267317
Name:DAVIS, CAROL M (PT,EDD,MS,FAPTA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT,EDD,MS,FAPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MONZA AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3005
Mailing Address - Country:US
Mailing Address - Phone:305-740-6001
Mailing Address - Fax:
Practice Address - Street 1:1500 MONZA AVE STE 350
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3005
Practice Address - Country:US
Practice Address - Phone:305-740-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2850225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist