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General NPI Number Information
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NPI Number | 1225443195
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Entity Type | Organization
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Legal Business Name | DONALD J WILLEMS, DO
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 1898 W HILLSBORO BLVD STE H
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1434
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Country | US
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Telephone | 954-571-9392
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Fax | 954-571-6788
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Provider Business Mailing Address
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Address Line | 1898 W HILLSBORO BLVD STE H
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1434
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Country | US
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Telephone | 954-571-9392
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Fax | 954-571-6788
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD J WILLEMS
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Credential | DO
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Telephone | 954-260-2363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | OS10400
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License Number State | FL
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