Healthcare Provider Details

I. General information

NPI: 1174971295
Provider Name (Legal Business Name): MRS. JENNIFER JUNE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 DR PHILLIPS BLVD SUITE 155
ORLANDO FL
32819-7216
US

IV. Provider business mailing address

7575 DR PHILLIPS BLVD STE 155
ORLANDO FL
32819-7220
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-8383
  • Fax: 407-650-2754
Mailing address:
  • Phone: 407-982-4876
  • Fax: 407-650-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: