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Organization

DAVID WILLIS DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID WILLIS D.O. (OWNER)
(407) 421-3599
Entity
Organization

Contact information

Practice address
919 LEATHER FERN LANE, MIMS, FL 32754
(407) 421-3599
Mailing address
919 LEATHER FERN LANE, MIMS, FL 32754
(407) 421-3599

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS9622
FL

Other

Enumeration date
05/24/2007
Last updated
09/16/2008
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