Individual
TABITHA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
636 DEL PRADO BLVD S, CAPE CORAL, FL 33990-2668
(239) 772-6513
Mailing address
PO BOX 7518, FORT MYERS, FL 33911-7518
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME92332
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01592
BLUE SHIELD
FL
05
—
272028100
—
FL
01
—
P00372910
RAILRAOD MEDICARE
FL
Enumeration date
04/21/2006
Last updated
01/29/2015
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