MEDICARE: COLBY BRANDON WILLIAMS

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	3747P1801X	Personal Care Attendant	321515456	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	:	1629592266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLBY BRANDON WILLIAMS

Provider Business Mailing Address
First Line	:	2846 NW 9TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-6667
Country	:	US
Telephone Number	:	754-244-3351
Fax Number	:

Provider Business Practice Location Address
First Line	:	2846 NW 9TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-6667
Country	:	US
Telephone Number	:	754-244-3351
Fax Number	:

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

Provider Enumeration Date	:	07/26/2017
Last Update Date	:	07/21/2022

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