Provider Demographics
NPI:1396372306
Name:WILLIAMS, WARREN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:ANDREW
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 S. ORANGE AVE.
Mailing Address - Street 2:5TH FL, MP# 43
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:321-841-1764
Mailing Address - Fax:
Practice Address - Street 1:1222 S. ORANGE AVE.
Practice Address - Street 2:5TH FL, MP# 43
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:321-841-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program