Provider Demographics
NPI:1194210807
Name:WILLIAMS, LYNVAL W JR (ARNP)
Entity type:Individual
Prefix:MR
First Name:LYNVAL
Middle Name:W
Last Name:WILLIAMS
Suffix:JR
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:157 BALTIMORE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2472
Mailing Address - Country:US
Mailing Address - Phone:301-722-0484
Mailing Address - Fax:833-903-0130
Practice Address - Street 1:1507 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2608
Practice Address - Country:US
Practice Address - Phone:301-722-0484
Practice Address - Fax:833-903-0130
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN364SF0001X
FL11000722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health