Provider Demographics
NPI:1508941576
Name:MARIE L WILLIAMS DPM PA
Entity Type:Organization
Organization Name:MARIE L WILLIAMS DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-932-9232
Mailing Address - Street 1:21000 NE 28TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1421
Mailing Address - Country:US
Mailing Address - Phone:305-932-9232
Mailing Address - Fax:305-932-1421
Practice Address - Street 1:21000 NE 28TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1421
Practice Address - Country:US
Practice Address - Phone:305-932-9232
Practice Address - Fax:305-932-1421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72751Medicare ID - Type Unspecified
FL3856940001Medicare NSC