Provider Demographics
NPI:1013951995
Name:WILLIAMS, ANGELA Y
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:Y
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100548
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33310-0548
Mailing Address - Country:US
Mailing Address - Phone:754-422-1379
Mailing Address - Fax:954-677-7525
Practice Address - Street 1:1221 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-3650
Practice Address - Country:US
Practice Address - Phone:754-422-1379
Practice Address - Fax:954-677-2575
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL321-00033941744R1103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder