Organization
OTHER PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA A WILLIAMS (ARNP)
(772) 285-7449
Entity
Organization
Contact information
Practice address
714 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33603-3104
(772) 285-7449
Mailing address
714 WEST DR MLK JR BLVD, TAMPA, FL 33603
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
06/21/2016
Last updated
07/28/2016
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