Provider Demographics
NPI:1649238064
Name:WILLIAMS, KAREN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3075 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4318
Mailing Address - Country:US
Mailing Address - Phone:954-772-1710
Mailing Address - Fax:954-491-6419
Practice Address - Street 1:5333 N DIXIE HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3414
Practice Address - Country:US
Practice Address - Phone:954-772-1710
Practice Address - Fax:954-772-2515
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0064916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23852OtherBC/BS
FLF75009Medicare UPIN
FL23852Medicare ID - Type Unspecified