Provider Demographics
NPI:1477806743
Name:WILLIAMS, RHONDA LEVETTE
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEVETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11134
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-1134
Mailing Address - Country:US
Mailing Address - Phone:386-275-6463
Mailing Address - Fax:
Practice Address - Street 1:827 KOTTLE CIR N
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4720
Practice Address - Country:US
Practice Address - Phone:386-275-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator