Healthcare Provider Details

I. General information

NPI: 1003729286
Provider Name (Legal Business Name): JOHNATHAN C WILLIAMSON PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38B COLLINGWOOD LN
PALM COAST FL
32137-8919
US

IV. Provider business mailing address

38B COLLINGWOOD LN
PALM COAST FL
32137-8919
US

V. Phone/Fax

Practice location:
  • Phone: 850-326-3441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberPMD538468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: