Provider Demographics
NPI:1821065061
Name:WILLIAMS, CHANDRA ROBINSON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:ROBINSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W ALEXANDER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-7116
Mailing Address - Country:US
Mailing Address - Phone:813-659-9800
Mailing Address - Fax:813-659-9807
Practice Address - Street 1:511 W ALEXANDER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7116
Practice Address - Country:US
Practice Address - Phone:813-659-9800
Practice Address - Fax:813-659-9807
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061174208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14644OtherBCBS
FL057720100Medicaid
FL14644ZMedicare ID - Type Unspecified
FLE68740Medicare UPIN