Provider Demographics
NPI:1992891055
Name:WILLIAMS, LAURA DENISE (ARNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:L
Other - Middle Name:DENISE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:9500 S DADELAND BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:786-530-3820
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:4531 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2770
Practice Address - Country:US
Practice Address - Phone:850-436-4563
Practice Address - Fax:850-436-4570
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2027602363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY016JOtherBCBS OF FLORIDA
500008484OtherRAILROAD MEDICARE
AL891001320Medicaid
FL300717100Medicaid
AL059009427OtherBCBS OF ALABAMA
AL891001320Medicaid
S88749Medicare UPIN