Healthcare Provider Details

I. General information

NPI: 1487005864
Provider Name (Legal Business Name): KARA LEVERETTE WILLIAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N CLYDE MORRIS BLVD
DAYTONA BEACH FL
32114-2709
US

IV. Provider business mailing address

201 N CLYDE MORRIS BLVD STE 200
DAYTONA BEACH FL
32114-2765
US

V. Phone/Fax

Practice location:
  • Phone: 386-425-0141
  • Fax: 386-254-7545
Mailing address:
  • Phone: 386-254-4165
  • Fax: 386-254-4339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23597
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME134068
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number105643
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: