Provider Demographics
NPI:1306969472
Name:WILLIAMS, JEFFREY LEE (RPH)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6988 BRESCIA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5288
Mailing Address - Country:US
Mailing Address - Phone:407-351-3020
Mailing Address - Fax:
Practice Address - Street 1:1401 S HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5715
Practice Address - Country:US
Practice Address - Phone:407-295-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH0015810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist