Chalandra Davis
Individual provider Active NPI Developmental Disabilities Clinic/Center · Tavares, FL
NPI 1639644693 · NPPES record last updated Oct 5, 2018
Key facts
- NPI
- 1639644693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Disabilities Clinic/Center 261QD1600X
- Practice address
- 3804 Windy Meadow Dr
Tavares, FL 32778-6102 - Phone
- (352) 448-5415
- NPI assigned
- Oct 5, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ajs Caring Heart Services LLC | Developmental Disabilities | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | Yes |
Addresses
Primary practice location
3804 Windy Meadow Dr
Tavares, FL 32778-6102
Mailing address
PO Box 1924
Tavares, FL 32778-1924
Phone (352) 448-5415
Other providers in Tavares, FL
- Laura Elizabeth Dalley
- Michaela Daniels
- Perry Dave
- David F Fernandez, MD, PA
- David L. Frerking D.C.P.a.
- Dynasty Davis
- Sandra F Dawson
- Carlos De la Torre
- Hector M De Leon
- Raphael Adroaldo De Oliveira Bertasi
All providers in Tavares, FL · Developmental Disabilities Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.