Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS0008109 | FL |
NPI | 1033101464 |
---|---|
Provider Name | Ronald Williams |
First Address | Palm Harbor, FL 34684-1109 |
Second Address | Palm Harbor, FL 34684-1109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H49133 | (02) | FL |