Provider Demographics
NPI:1821164245
Name:WILLIAMS, SYLVIA CHRISTINE (OD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:CHRISTINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 MADACA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2057
Mailing Address - Country:US
Mailing Address - Phone:813-962-1006
Mailing Address - Fax:813-269-0600
Practice Address - Street 1:3604 MADACA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2057
Practice Address - Country:US
Practice Address - Phone:813-962-1006
Practice Address - Fax:813-269-0600
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2215152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3821YMedicare PIN
FLU794120001Medicare UPIN