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General NPI Number Information
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NPI Number | 1679623227
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Entity Type | Individual
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Provider Name | MADONNA P WILLIAMS OTR
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 03/20/2020
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Provider Practice Location Address
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Address Line | 2987 RIDERS PASS
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City | ODESSA
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State | FL
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Zip | 33556-3123
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Country | US
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Telephone | 727-687-6958
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Fax | 727-375-2924
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Provider Business Mailing Address
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Address Line | 2987 RIDERS PASS
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City | ODESSA
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State | FL
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Zip | 33556-3123
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Country | US
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Telephone | 727-687-6958
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Fax | 727-375-2924
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 5996
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License Number State | FL
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