Provider Demographics
NPI:1164966305
Name:WILLIAMS, MATTHEW Z
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:Z
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 S OCEAN DR
Mailing Address - Street 2:APT 1604
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2529
Mailing Address - Country:US
Mailing Address - Phone:313-510-8346
Mailing Address - Fax:
Practice Address - Street 1:2101 S OCEAN DR
Practice Address - Street 2:APT 1604
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2529
Practice Address - Country:US
Practice Address - Phone:313-510-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program