Provider Demographics
NPI:1699032979
Name:WILLIAMS, FAMEISHA RENE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:FAMEISHA
Middle Name:RENE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 N ORANGE AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5521
Mailing Address - Country:US
Mailing Address - Phone:407-303-2474
Mailing Address - Fax:407-303-0678
Practice Address - Street 1:2415 N ORANGE AVE STE 700
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5521
Practice Address - Country:US
Practice Address - Phone:407-303-2474
Practice Address - Fax:407-303-0678
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9248075363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056071500Medicaid
FL00364OtherMEDICARE ID-TYPE UNSPECIFIED