| Stephen P. Davis, Ph.d., P.a. | |
|
2400 Se Midport Rd Suite 211 Port St Lucie FL 34952-4823 | |
| (772) 398-1003 | |
| (772) 398-1772 |
| Full Name | Stephen P. Davis, Ph.d., P.a. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2400 Se Midport Rd, Port St Lucie, Florida |
| Authorized Official Name and Position | Stephen P. Davis (PRESIDENT) |
| Authorized Official Contact | 7723981003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen P. Davis, Ph.d., P.a. 2400 Se Midport Rd Suite 211 Port St Lucie FL 34952-4823 Ph: (772) 398-1003 | Stephen P. Davis, Ph.d., P.a. 2400 Se Midport Rd Suite 211 Port St Lucie FL 34952-4823 Ph: (772) 398-1003 |
| NPI Number | 1831123173 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831123173 | NPI | - | NPPES |
| 125175 | Other | FL | VALUE OPTIONS |
| 10745971 | Other | FL | AETNA |
| 82322 | Other | FL | CIGNA |
| IP029180 | Other | FL | MAGELLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 5785 (Florida) | Primary |
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