Healthcare Provider Details

I. General information

NPI: 1295685204
Provider Name (Legal Business Name): MRS. GAIL WILLIAMS ROE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 BRACKEN LN
BRANDON FL
33511-7571
US

IV. Provider business mailing address

317 BRACKEN LN
BRANDON FL
33511-7571
US

V. Phone/Fax

Practice location:
  • Phone: 813-405-7021
  • Fax:
Mailing address:
  • Phone: 813-405-7021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number9291243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: