Organization Active NPI

Marian Davis DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Miami, FL
National Provider Identifier
1962674903
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 3333 Issued in FL
Legal business name
MARIAN DAVIS DPM PA
Practice address
1190 NW 95TH St Ste 401
Miami, FL 33150-2067
Phone
(305) 835-8000
Fax
(305) 835-0866
NPI assigned
Mar 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Imaze Marian Davis, DPMNPI 1629249925
Title
President/Owner
Phone
(305) 479-5090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO 3333 FL Primary

Addresses

Primary practice location

1190 NW 95TH St Ste 401
Miami, FL 33150-2067

Mailing address

1190 NW 95TH St
Suite 108
Miami, FL 33150-2063
Phone (305) 835-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080729000565 FL Part B Supplier - Clinic/Group Practice 1355415050 Receives reassigned benefits from 4 practitioners
Practice locations: Aventura, FL; Miami, FL; North Miami Beach, FL; Palmetto Bay, FL; South Miami, FL
O20101013000330 FL DME Supplier - Physician - Podiatry 1355415050 Practice locations: Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2144525Marian Davis DPM PA1190 NW 95TH St Ste 401, Miami, FL 33150AccreditationJan 30, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1962674903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST",
            "address_2": "SUITE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502063",
            "telephone_number": "305-835-8000",
            "fax_number": "305-835-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST STE 401",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502067",
            "telephone_number": "305-835-8000",
            "fax_number": "305-835-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAN DAVIS DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "IMAZE",
        "authorized_official_middle_name": "MARIAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "305-479-5090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.