Healthcare Provider Details

I. General information

NPI: 1124966288
Provider Name (Legal Business Name): DEMETRICE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 S MILITARY TRL STE 1-1013
WEST PALM BEACH FL
33415-3962
US

IV. Provider business mailing address

770 S MILITARY TRL STE 1-1013
WEST PALM BEACH FL
33415-3962
US

V. Phone/Fax

Practice location:
  • Phone: 561-541-3577
  • Fax: 561-541-3577
Mailing address:
  • Phone: 561-541-3577
  • Fax: 561-541-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: