Healthcare Provider Details

I. General information

NPI: 1568112282
Provider Name (Legal Business Name): KEIRA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W NEWBERRY RD
GAINESVILLE FL
32605-4309
US

IV. Provider business mailing address

1105 FORT CLARKE BLVD APT 806
GAINESVILLE FL
32606-7131
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME175760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: