Healthcare Provider Details

I. General information

NPI: 1851534473
Provider Name (Legal Business Name): CAROL DEE WILLIAMS LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 W 80TH ST
HIALEAH FL
33014-4164
US

IV. Provider business mailing address

793 W 80TH ST
HIALEAH FL
33014-4164
US

V. Phone/Fax

Practice location:
  • Phone: 786-514-1719
  • Fax:
Mailing address:
  • Phone: 786-514-1719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW179
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: