Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | FL |
NPI | 1750931523 |
---|---|
Provider Name | Sylvia Diane Williams |
First Address | Titusville, FL 32780-3219 |
Second Address | Titusville, FL 32780-3219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2019 |
Last Update Date | 13/09/2019 |