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General NPI Number Information
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NPI Number | 1700130234
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Entity Type | Individual
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Provider Name | WILMA JOY WILLIAMS-BLAKE ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 11/06/2012
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Provider Practice Location Address
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Address Line | 700 N HIATUS RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5206
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Country | US
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Telephone | 954-392-9026
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Fax |
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Provider Business Mailing Address
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Address Line | 4936 SW 166TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-4904
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Country | US
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Telephone | 954-696-4405
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9165385
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License Number State | FL
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