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General NPI Number Information
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NPI Number | 1922482009
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Entity Type | Individual
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Provider Name | RYLEY SCOTT WILLIAMS PA-C, ATC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 255 N LAKEMONT AVE STE 207
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City | WINTER PARK
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State | FL
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Zip | 32792-3219
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Country | US
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Telephone | 844-407-4070
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Fax | 407-743-3050
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST STE 520
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4430
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Country | US
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Telephone | 609-677-7003
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Fax | 267-339-3761
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL2688
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAT9108971
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9108971
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License Number State | FL
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