Individual
KENNETH WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5325 26TH ST W, BRADENTON, FL 34207-3012
(941) 708-8500
(941) 708-8503
Mailing address
PO BOX 997, PALMETTO, FL 34220-0997
(941) 776-4000
(941) 776-4013
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002415900
—
FL
Enumeration date
08/24/2015
Last updated
09/21/2015
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