Basic Information
Provider Information
NPI: 1770664328
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: MELISSA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WILLIAMS
OtherFirstName: MELISSA
OtherMiddleName: LYNN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 400 N ASHLEY DR
Address2: SUITE 1625
City: TAMPA
State: FL
PostalCode: 336024300
CountryCode: US
TelephoneNumber: 8135146387
FaxNumber: 8138444972
Practice Location
Address1: 1 TAMPA GENERAL CIR
Address2: SUITE A327
City: TAMPA
State: FL
PostalCode: 336063571
CountryCode: US
TelephoneNumber: 8138444434
FaxNumber: 8138444972
Other Information
ProviderEnumerationDate: 10/18/2006
LastUpdateDate: 06/05/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XME 100074FLY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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