Healthcare Provider Details

I. General information

NPI: 1568272276
Provider Name (Legal Business Name): JENEE WILLIAMS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 NE 191ST ST STE 230
AVENTURA FL
33180-3115
US

IV. Provider business mailing address

12705 NW 27TH AVE APT 302
MIAMI FL
33167-1993
US

V. Phone/Fax

Practice location:
  • Phone: 305-935-4551
  • Fax:
Mailing address:
  • Phone: 786-916-1293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT42518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: