Individual
ANGELA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
(904) 697-3927
Mailing address
10140 CENTURION PKWY N, PROVIDER ENROLLMENT DEPARTMENT, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017822100
—
FL
Enumeration date
03/26/2014
Last updated
07/21/2022
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