Provider Demographics
NPI:1346389608
Name:WILLIAMS, MICHAEL E (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
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 1:1810 CAULFIELD DR.
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-1510
Mailing Address - Country:US
Mailing Address - Phone:941-587-2980
Mailing Address - Fax:
Practice Address - Street 1:2828 S MCCALL RD
Practice Address - Street 2:SUITE 22
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-7791
Practice Address - Country:US
Practice Address - Phone:941-475-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6231111N00000X
CA14811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT05514Medicare UPIN
FL22543Medicare ID - Type Unspecified