Provider Demographics
NPI:1487005864
Name:WILLIAMS, KARA LEVERETTE (MD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LEVERETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:201 N CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2724
Mailing Address - Country:US
Mailing Address - Phone:386-254-4165
Mailing Address - Fax:386-254-4339
Practice Address - Street 1:303 N CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-425-0141
Practice Address - Fax:386-254-7545
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23597207Q00000X
FLME134068207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine