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General NPI Number Information
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NPI Number | 1174230288
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Entity Type | Individual
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Provider Name | URIAH JORDAN WILLIAMS SR.
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Gender | Male
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 3808 EXETER LN
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City | LAKELAND
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State | FL
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Zip | 33810-2419
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Country | US
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Telephone | 813-892-8598
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Fax | 800-507-6586
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Provider Business Mailing Address
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Address Line | 3808 EXETER LN
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City | LAKELAND
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State | FL
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Zip | 33810-2419
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Country | US
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Telephone | 813-892-8598
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Fax | 800-507-6586
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State | FL
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