Individual
DR. NANCY E WILLIAMS-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
36422 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1330
(727) 772-7712
(727) 772-6891
Mailing address
2559 CENTENNIAL FALCON DR, VALRICO, FL 33596-6310
(813) 299-4931
(727) 772-6891
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME69004
FL
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
ME69004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378657900
—
FL
Enumeration date
06/23/2006
Last updated
12/07/2018
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