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Organization
TOWN CENTER FAMILY CARE LLC
Active
Organization
TOWN CENTER FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONNETTE WILLIAMS MD (OWNER)
(386) 437-7977
Entity
Organization
Contact information
Practice address
21 HOSPITAL DR, STE 290, PALM COAST, FL 32164-2380
(386) 473-7977
(386) 437-7732
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 824-4990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME61253
FL
302F00000X
Exclusive Provider Organization
ME61253
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y81BD
FL BLUE
FL
Enumeration date
04/08/2008
Last updated
03/07/2017
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