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General NPI Number Information
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NPI Number | 1528396058
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Entity Type | Organization
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Legal Business Name | DUNN AVENUE HEALTH AND WELLNESS CENTER INC
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 3450 DUNN AVE STE. 302
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6426
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Country | US
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Telephone | 904-329-1904
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Fax | 904-329-1905
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Provider Business Mailing Address
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Address Line | 3450 DUNN AVE STE. 302
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6426
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Country | US
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Telephone | 904-329-1904
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Fax | 904-329-1905
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. EDWARD WILLIAMS JR.
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Credential | D.O.
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Telephone | 904-329-1904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 6019
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License Number State | FL
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