Healthcare Provider Details

I. General information

NPI: 1215980933
Provider Name (Legal Business Name): WILLIAM ALFRED MILLS JR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3986 LAKE WARREN DRIVE
ORLANDO FL
32812
US

IV. Provider business mailing address

3986 LAKE WARREN DRIVE
ORLANDO FL
32812
US

V. Phone/Fax

Practice location:
  • Phone: 407-856-7385
  • Fax: 407-856-7385
Mailing address:
  • Phone: 407-856-7385
  • Fax: 407-856-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberP02512
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: