Basic Information
| Provider Information | |||||||||
| NPI: | 1427364082 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ROSEMARIE | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4960 SW 72ND AVE | ||||||||
| Address2: | #406 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331555544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056625200 | ||||||||
| FaxNumber: | 3052847948 | ||||||||
| Practice Location | |||||||||
| Address1: | 9030 KIMBERLY BLVD | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334342823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614882300 | ||||||||
| FaxNumber: | 5614876704 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2010 | ||||||||
| LastUpdateDate: | 08/20/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | PN5156356 | FL | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.