Healthcare Provider Details

I. General information

NPI: 1295109726
Provider Name (Legal Business Name): DAVID KEVIN WILLIAMS R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 SW 13TH ST
GAINESVILLE FL
32608-4006
US

IV. Provider business mailing address

4300 SW13TH STREET
GAINESVILLE FL
32608-4006
US

V. Phone/Fax

Practice location:
  • Phone: 352-258-3138
  • Fax:
Mailing address:
  • Phone: 352-258-3138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2852382
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberRN2852382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: