Provider Demographics
NPI:1326223942
Name:WILLIAMS, ROSS (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3367
Mailing Address - Country:US
Mailing Address - Phone:305-292-7222
Mailing Address - Fax:305-295-7555
Practice Address - Street 1:1217 WHITE ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3367
Practice Address - Country:US
Practice Address - Phone:305-292-7222
Practice Address - Fax:305-295-7555
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88042Medicare PIN
FLT06572Medicare UPIN