Provider Demographics
NPI:1154329159
Name:WILLIAMS, FLO (RRT)
Entity Type:Individual
Prefix:MS
First Name:FLO
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 NW 141ST AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2853
Mailing Address - Country:US
Mailing Address - Phone:954-704-4440
Mailing Address - Fax:954-704-4470
Practice Address - Street 1:2028 NW 141ST AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2853
Practice Address - Country:US
Practice Address - Phone:954-704-4440
Practice Address - Fax:954-704-4470
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2009-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT34732279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884465800Medicaid