Healthcare Provider Details

I. General information

NPI: 1508760034
Provider Name (Legal Business Name): THADEUS L WILLIAMS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1239 NW 67TH ST
OCALA FL
34475-8590
US

IV. Provider business mailing address

1239 NW 67TH ST
OCALA FL
34475-8590
US

V. Phone/Fax

Practice location:
  • Phone: 407-752-4011
  • Fax:
Mailing address:
  • Phone: 407-752-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: