=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477153518
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXANDREA DANIELLE WILLIAMS DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2020
-----------------------------------------------------
Last Update Date | 06/13/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15202 NW 147TH DR STE 1500
-----------------------------------------------------
City | ALACHUA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32615-5337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-359-3192
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17246 NW 173RD DR
-----------------------------------------------------
City | ALACHUA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32615-0060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-792-5002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH13273
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------