Provider Demographics
NPI:1710142351
Name:WILLIAMS, DENISE M (LMT)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AP, LMT
Mailing Address - Street 1:100 2ND AVE S STE 904S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4354
Mailing Address - Country:US
Mailing Address - Phone:727-603-3205
Mailing Address - Fax:
Practice Address - Street 1:100 2ND AVE S STE 904S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4354
Practice Address - Country:US
Practice Address - Phone:727-804-3847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 53587225700000X
FLAP4616171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist