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1508872516

NPI Code Detail

MEDICARE: DR. LAUREN D WILLIAMS MD

MEDICARE: DR. LAUREN D WILLIAMS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	70024	CT
2	2084P0802X	Addiction Psychiatry Physician	ME63449	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508872516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN D WILLIAMS MD

Provider Business Mailing Address
First Line	:	10064 SW 164TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-4884
Country	:	US
Telephone Number	:	305-282-3883
Fax Number	:

Provider Business Practice Location Address
First Line	:	3625 UNIVERSITY BLVD S
Second Line	:	MEMORIAL BEHAVIORAL HEALTH
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4207
Country	:	US
Telephone Number	:	904-399-6353
Fax Number	:	904-399-6354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	10/21/2022

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Directions to “ DR. LAUREN D WILLIAMS MD” Practice Location

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