Healthcare Provider Details

I. General information

NPI: 1295559029
Provider Name (Legal Business Name): BROWNHILL LEGACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 DOUGLAS AVE STE 2500
ALTAMONTE SPRINGS FL
32714-3391
US

IV. Provider business mailing address

385 DOUGLAS AVE STE 2500
ALTAMONTE SPRINGS FL
32714-3391
US

V. Phone/Fax

Practice location:
  • Phone: 407-749-1221
  • Fax:
Mailing address:
  • Phone: 407-749-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAMOL WILLIAMS
Title or Position: PHYSICIAN
Credential: MD
Phone: 407-749-1221