Provider Demographics
NPI:1790731446
Name:WILLIAMS, TIMOTHY R (MD)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1599 NW 9TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1310
Mailing Address - Country:US
Mailing Address - Phone:561-368-4998
Mailing Address - Fax:561-584-7775
Practice Address - Street 1:5280 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6516
Practice Address - Country:US
Practice Address - Phone:561-323-6498
Practice Address - Fax:561-584-7775
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME450712085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069798200Medicaid
FL01393XMedicare PIN
FL01393ZMedicare PIN
FLC89607Medicare UPIN