Provider Demographics
NPI:1144477761
Name:DAVIS, JOANIE BETH (AUD)
Entity type:Individual
Prefix:DR
First Name:JOANIE
Middle Name:BETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JOANIE
Other - Middle Name:BETH
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4075 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2467
Mailing Address - Country:US
Mailing Address - Phone:352-666-8910
Mailing Address - Fax:352-683-6889
Practice Address - Street 1:4075 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2467
Practice Address - Country:US
Practice Address - Phone:352-666-8910
Practice Address - Fax:352-683-6889
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231H00000X
FLAY1502231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY1502OtherFLORIDA MEDICAL LICENSE
FL015606400Medicaid