Provider Demographics
NPI:1477082980
Name:WILLIAMS, ANTON RICHARD JR
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:RICHARD
Last Name:WILLIAMS
Suffix:JR
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 1:413 QUAIL WOOD LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2767
Mailing Address - Country:US
Mailing Address - Phone:321-202-0429
Mailing Address - Fax:
Practice Address - Street 1:413 QUAIL WOOD LN
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2767
Practice Address - Country:US
Practice Address - Phone:321-202-0429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty