MEDICARE: MISS MICHELLE DENISE WILLIAMS P.A.

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
1	363A00000X	Physician Assistant	PA9108020	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1619370624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MICHELLE DENISE WILLIAMS P.A.

Provider Business Mailing Address
First Line	:	PO BOX 41516
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32203-1516
Country	:	US
Telephone Number	:	904-202-5111
Fax Number	:	904-391-5836

Provider Business Practice Location Address
First Line	:	1747 BAPTIST CLAY DR STE 230
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8505
Country	:	US
Telephone Number	:	904-592-1068
Fax Number	:	904-390-7386

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2014
Last Update Date	:	04/05/2018

Similar Medicare Providers

1427875319 — KRISTEN BURGSTINER APRN
Practice Location Address:

1747 BAPTIST CLAY DR STE 230
FLEMING ISLAND, FL
32003-8505

Practice Phone: 904-592-1068
Practice Fax:

1528266541 — RONNY L SAVAGE OT
Practice Location Address:

1747 BAPTIST CLAY DR STE 210
FLEMING ISLAND, FL
32003-8505

Practice Phone: 904-621-0396
Practice Fax: 904-621-0397

1922425560 — DR. CAROLINE R KISER D.P.M.
Practice Location Address:

1747 BAPTIST CLAY DR STE 200
FLEMING ISLAND, FL
32003-8505

Practice Phone: 904-202-6683
Practice Fax: 904-376-3062

1629495981 — KURT ALAN MADZUNOVIC DO
Practice Location Address:

1747 BAPTIST CLAY DR STE 200
FLEMING ISLAND, FL
32003-8505

Practice Phone: 904-516-1950
Practice Fax: 904-376-3062

1295149821 — DR. NICHOLAS J SACKSTEDER MD
Practice Location Address:

1747 BAPTIST CLAY DR STE 200
FLEMING ISLAND, FL
32003-8505

Practice Phone: 904-276-5776
Practice Fax: 904-276-5958

1477943579 — HARRISON S MAHON MD
Practice Location Address:

1747 BAPTIST CLAY DR STE 200
FLEMING ISLAND, FL
32003-8505

Practice Phone: 904-161-9503
Practice Fax: 904-376-3062

Directions to “ MISS MICHELLE DENISE WILLIAMS P.A.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.