MEDICARE: MARK LEE WILLIAMS D.C.

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	111N00000X	Chiropractor	CH10007	FL

General Provider Information

NPI Number	:	1841590361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK LEE WILLIAMS D.C.

Provider Business Mailing Address
First Line	:	1786 N MILLS AVE.
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-1852
Country	:	US
Telephone Number	:	407-985-2880
Fax Number	:	407-985-2879

Provider Business Practice Location Address
First Line	:	1786 N MILLS AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-1852
Country	:	US
Telephone Number	:	407-985-2880
Fax Number	:	407-985-2879

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

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	01/16/2013

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