Individual
SAMUEL WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
112 E DIXIE AVE, LEESBURG, FL 34748-6350
(352) 787-1956
(352) 365-6690
Mailing address
112 E DIXIE AVE, LEESBURG, FL 34748-6350
(352) 787-1956
(352) 365-6690
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC968
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078718300
—
FL
Enumeration date
09/20/2006
Last updated
12/04/2013
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