Provider Demographics
NPI:1649042839
Name:MAPLE, DAVINIA
Entity type:Individual
Prefix:
First Name:DAVINIA
Middle Name:
Last Name:MAPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12833 SUGAR CT
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32735-8978
Mailing Address - Country:US
Mailing Address - Phone:352-434-8913
Mailing Address - Fax:
Practice Address - Street 1:12833 SUGAR CT
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32735-8978
Practice Address - Country:US
Practice Address - Phone:352-434-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No253Z00000XAgenciesIn Home Supportive Care