Doctor Name: | MANDANA DAVANI |
NPI Number: | 1003883885 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | ME77783 |
Business Practice Address: | 400 Health Park Blvd Attn: Radiology Department Saint Augustine, FL - 320865784 |
Business Phone Number: | 9048194398 |
Business Fax Number: | 9048194976 |
Mailing Address: | 400 Health Park Blvd, Attn: Radiology Department SAINT AUGUSTINE |
State: | FL |
Postal Code: | 320865784 |
Phone Number: | 9048194398 |
Fax Number: | 9048194976 |
NPI Enumeration Date: | 03/01/2006 |
NPI Last Update Date: | 05/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | ME77783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |