DR. RANDAL DAVIS (NPI# 1649684952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649684952 |
| Entity Type | Individual |
| Full Name | DR. RANDAL DAVIS |
| Credential | D.O. |
| Practice Address |
7227 N Us Highway 1 Ste 100 Port St John FL 32927 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3216371595 |
| Practice Fax Number | 3216371596 |
| Mailing Telephone | 3216371595 |
| Mailing Fax Number | 3219517408 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2018-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS13584 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | PENDING | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1855 Knox Mcrae Dr, Titusville, FL 327805492 | 3212692028 | 3212640730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649704909 | Randal Davis | Speech-Language Pathologist | 11044 N 2040 Rd, Elk City, OK 73644-9386 | 2017-04-13 |
| 1134158702 | Randal L Davis | Emergency Medicine | 102 S. Charles G. Seviers Blvd, Clinton, TN 37716 | 2006-07-03 |
| Street Address |
7227 N US HIGHWAY 1 STE 100 |
| City | PORT ST JOHN |
| State | FL |
| Zip Code | 32927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740592815 | Saminder Singh | Family Medicine | 7227 N Us Highway 1 Ste 100, Port St John, FL 32927-5034 | 2010-07-06 |
| 1366965519 | Katherine Penny Leonard | Nurse Practitioner | 7227 N Us Highway 1 Ste 100, Port St John, FL 32927-5034 | 2017-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538565023 | Susan Guattery Coleman | Dietitian, Registered | 7075 Us Highway 1, Diabetes Education Suite 300, Port Saint John, FL 32927 | 2014-11-10 |
| 1245668086 | Betty Lopez Munarriz | Contractor | 5660 Fay Blvd, Cocoa, FL 32927 | 2013-10-14 |
| 1427499599 | Gary Ray Rudolph | Pharmacist | 7125 Us 1, Cocoa, FL 32927 | 2013-07-17 |
| 1659716165 | Tania Melissa Johnson | Social Worker | 5355 Date Palm St, Cocoa, FL 32927 | 2013-05-10 |
| 1538473137 | Irwin Jaraplasan | Dentist | 5235 Fay Blvd, Cocoa, FL 32927 | 2010-08-06 |
| 1386856110 | Tri M Le | Pharmacist | 6257 U.S. Hwy 1, Cocoa, FL 32927 | 2007-05-04 |
| 1134218357 | Rameshwar N Mathur Md Pa | Family Medicine | 6250 N Us 1, Cocoa, FL 32927 | 2006-10-12 |
| 1922035088 | Albino Y Kuon | Psychiatry & Neurology | 4360 North Us1, Cocoa, FL 32927 | 2006-06-26 |
| 1801855424 | Faye Ellen O'rourke | Nurse Practitioner | 7227 N. Us Hwy. 1, Port St. John, FL 32927 | 2006-03-22 |
| 1063965275 | Tiffany Williams-brown | Nurse Practitioner | 860 Camp Rd, Cocoa, FL 32927 | 2016-07-25 |
| Find all providers in zip 32927 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740592815 | Saminder Singh | Family Medicine | 7227 N Us Highway 1 Ste 100, Port St John, FL 32927-5034 | 2010-07-06 |
| 1164698932 | Benjamin Reed Nettleton | Family Medicine | 5005 Port St John Pkwy, Suite 2500, Port St John, FL 32927-4305 | 2008-05-01 |
| 1114010154 | Amber W Surber | Family Medicine | 7227 N Highway 1, Suite 100, Port St John, FL 32927-5020 | 2006-10-02 |
| 1497858724 | Wendy L Worsley | Family Medicine | 5005 Port St John Pkwy, Ste 2500, Port St John, FL 32927-4305 | 2006-09-05 |
| 1376510909 | Julie Lynn Flick | Family Medicine | 5005 Port St John Pkwy, Suite 2500, Port St John, FL 32927-4305 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891777 | Medical Risk Solutions LLC | Family Medicine | 455 Ishie Ave, Bronson, FL 32621-6204 | 2020-11-06 |
| 1801497953 | Wildwood Primary Care Associates | Family Medicine | 5814 Seven Mile Dr Ste 105, Wildwood, FL 34785-8869 | 2020-11-05 |
| 1053912238 | New Port Richey Primary Care Associates | Family Medicine | 4772 Us Highway 19, New Port Richey, FL 34652-4944 | 2020-11-04 |
| 1053912550 | Wound Integrity Florida Pa | Family Medicine | 111 Ne 1st St # 1011, Miami, FL 33132-2506 | 2020-11-03 |
| 1902407455 | Trek Healthcare LLC | Family Medicine | 11767 S Dixie Hwy # 208, Pinecrest, FL 33156-4438 | 2020-11-02 |
| 1700486933 | Orlando Jorge Diaz | Family Medicine | 6231 Sw 138th Ct Apt N, Miami, FL 33183-2095 | 2020-10-27 |
| 1255930871 | Haymee Rodriguez | Family Medicine | 18751 Sw 295th Ter, Homestead, FL 33030-2310 | 2020-10-23 |
| 1033718986 | Jason Wittlin | Family Medicine | 601 Sw 242nd Ter, Newberry, FL 32669-4495 | 2020-10-21 |
| 1457950420 | Paxton Medical Management | Family Medicine | 14279 Tamiami Trl, North Port, FL 34287-2215 | 2020-10-21 |
| 1679172779 | Flagler Family Nursing Home Care LLC | Family Medicine | 130 Healthpark Blvd, St Augustine, FL 32086-5776 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST JOHN |
| Zip Code | 32927 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.