Provider Demographics
NPI:1831781889
Name:WILLIAMS-MCCUMMINGS, GLORIA
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:WILLIAMS-MCCUMMINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12715 STANDBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7759
Mailing Address - Country:US
Mailing Address - Phone:813-928-9925
Mailing Address - Fax:
Practice Address - Street 1:7930 WOODLAND CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2436
Practice Address - Country:US
Practice Address - Phone:813-880-7644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty