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NPI Code Detail

MEDICARE: ANDREKIA WILLIAMS-MONTGOMERY MA, PBT

MEDICARE:   ANDREKIA  WILLIAMS-MONTGOMERY  MA, PBT
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
1291U00000XClinical Medical Laboratory828224FL

General Provider Information

NPI Number : 1982159703
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREKIA WILLIAMS-MONTGOMERY MA, PBT
Provider Business Mailing Address
First Line : 1471 NW 22ND CT APT 1
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311-3545
Country : US
Telephone Number : 954-709-9849
Fax Number : 702-554-5096
Provider Business Practice Location Address
First Line : 1471 NW 22ND CT APT 1
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311-3545
Country : US
Telephone Number : 954-709-9849
Fax Number : 702-554-5096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2016
Last Update Date : 08/22/2016

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Directions to “ ANDREKIA WILLIAMS-MONTGOMERY MA, PBT” Practice Location

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