Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 23597 | FL |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME134068 | FL |
NPI | 1487005864 |
---|---|
Provider Name | Kara Leverette Williams |
First Address | Daytona Beach, FL 32114-2724 |
Second Address | Daytona Beach, FL 32114-2709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 17/08/2020 |