Healthcare Provider Details

I. General information

NPI: 1366077950
Provider Name (Legal Business Name): MEGHAN WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date: 08/29/2023
Reactivation Date: 09/27/2023

III. Provider practice location address

1118 S ORANGE AVE STE 103
ORLANDO FL
32806-1200
US

IV. Provider business mailing address

1118 S ORANGE AVE STE 103
ORLANDO FL
32806-1200
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-9585
  • Fax:
Mailing address:
  • Phone: 407-896-9585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number67.000600
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number20-111799
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: