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NPI Code Detail

MEDICARE: MICHELLE MCWILLIAMS SLP

MEDICARE:   MICHELLE  MCWILLIAMS  SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist9115FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609428051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MCWILLIAMS SLP
Provider Business Mailing Address
First Line : 8777 SAN JOSE BLVD STE 701
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4292
Country : US
Telephone Number : 904-733-8255
Fax Number :
Provider Business Practice Location Address
First Line : 8777 SAN JOSE BLVD STE 701
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4292
Country : US
Telephone Number : 904-733-8255
Fax Number : 904-733-5034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2019
Last Update Date : 07/15/2019

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Directions to “ MICHELLE MCWILLIAMS SLP” Practice Location

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