Healthcare Provider Details

I. General information

NPI: 1285423509
Provider Name (Legal Business Name): ALEXANDER MICHAEL WILLIAMS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 RIGGINS RD
TALLAHASSEE FL
32308-5316
US

IV. Provider business mailing address

PO BOX 13834
TALLAHASSEE FL
32317-3834
US

V. Phone/Fax

Practice location:
  • Phone: 850-205-6232
  • Fax: 850-942-4112
Mailing address:
  • Phone: 850-205-6232
  • Fax: 855-975-0615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9120172
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: