Healthcare Provider Details

I. General information

NPI: 1154237527
Provider Name (Legal Business Name): ADVANCED ORTHOPEDIC CENTER OF CHARLOTTE COUNTY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18669 TAMIAMI TRL
NORTH PORT FL
34287-7388
US

IV. Provider business mailing address

1641 TAMIAMI TRL
PORT CHARLOTTE FL
33948-1018
US

V. Phone/Fax

Practice location:
  • Phone: 941-629-6262
  • Fax: 941-629-1782
Mailing address:
  • Phone: 941-629-6262
  • Fax: 941-629-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN MASTERS WILLIAMS II
Title or Position: CEO
Credential: DPT, MBA
Phone: 256-606-2433