Provider Demographics
NPI:1558727818
Name:WILLIAMS, MARIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:GULINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:253 SW WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MAYO
Mailing Address - State:FL
Mailing Address - Zip Code:32066-4043
Mailing Address - Country:US
Mailing Address - Phone:386-294-3462
Mailing Address - Fax:
Practice Address - Street 1:259 SW CAPTAIN BROWN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-4316
Practice Address - Country:US
Practice Address - Phone:850-973-8277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-01
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 15197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist