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Individual

MR. MARK EDWARD WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1401 S APOLLO BLVD, SUITE B, MELBOURNE, FL 32901-3179
(321) 725-5151
(321) 725-5157
Mailing address
2160 N HIGHWAY A1A, UNIT 104, INDIALANTIC, FL 32903-2559
(321) 725-5151
(321) 725-5157

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9243193
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BCBS G2420
BCBS
FL
Enumeration date
03/07/2007
Last updated
05/19/2008
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