Provider Demographics
NPI:1396998340
Name:DAVIS, JANINA M (ARNP-C)
Entity type:Individual
Prefix:MS
First Name:JANINA
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 691326
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-1326
Mailing Address - Country:US
Mailing Address - Phone:407-420-7952
Mailing Address - Fax:407-420-7953
Practice Address - Street 1:10960 DYLAN LOREN CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4439
Practice Address - Country:US
Practice Address - Phone:407-420-7952
Practice Address - Fax:407-420-7953
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1143902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307210001Medicaid
FLY0A6VOtherBCBS
FL307210001Medicaid