Healthcare Provider Details

I. General information

NPI: 1588244750
Provider Name (Legal Business Name): OPHELIA MEDICAL GROUP FL, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 CECIL B MOORE AVE APT 204
PHILADELPHIA PA
19122-3243
US

IV. Provider business mailing address

228 PARK AVE S STE 15314
NEW YORK NY
10003-1502
US

V. Phone/Fax

Practice location:
  • Phone: 215-585-2144
  • Fax: 267-780-7032
Mailing address:
  • Phone: 215-585-2144
  • Fax: 267-780-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR R WILLIAMS
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 215-585-2144