Edmond-Davis, Victoria

Edmond-Davis, Victoria is an individual health care provider with primary practice located at 119 Oakfield Dr , Brandon FL 33511-5779. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Edmond-Davis, Victoria can be contacted via phone (904) 236-5884.

Contact Information

Primary practice address
119 Oakfield Dr Brandon FL 33511-5779
Phone: (904) 236-5884
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X D0087992 Maryland
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0101240073 Virginia
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME162702 Florida

Profile Details

NPI number 1265471676
LBN Legal business name Edmond-Davis, Victoria
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Sep 5th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265471676 NPPES
Virginia MEDICAID 010304105
Virginia Other 1371666
Virginia MEDICAID 200381160
Virginia Other 0090
Virginia Other 7278394
Virginia Other 260000
Virginia MEDICAID 010304083

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