Provider Demographics
NPI:1205128998
Name:WILLIAMS, JASON ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ANTONIO
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2201 CENTRAL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8844
Mailing Address - Country:US
Mailing Address - Phone:727-914-0200
Mailing Address - Fax:727-201-8905
Practice Address - Street 1:2201 CENTRAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8844
Practice Address - Country:US
Practice Address - Phone:727-914-0200
Practice Address - Fax:727-201-8905
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-00248622084N0400X
FLME1238342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology