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Organization
LEGACY HEALTHCARE CENTER LLC
Active
Organization
LEGACY HEALTHCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALOREA WILLIAMS (APRN)
(352) 256-5933
Entity
Organization
Contact information
Practice address
3620 NW 43RD ST STE A-C, GAINESVILLE, FL 32606-8103
(325) 575-9991
(601) 429-9159
Mailing address
113 WOODLAND LN, HAWTHORNE, FL 32640-6343
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107662400
—
FL
Enumeration date
10/18/2021
Last updated
02/10/2022
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