| Entity Name: | STEPHEN A. WILLIAMS, M.D., INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Oct 2000 (24 years ago) |
| Document Number: | P00000093701 |
| FEI/EIN Number | 593680172 |
| Address: | 8000 SW 117TH AVENUE, MIAMI, FL, 33183, US |
| Mail Address: | 8000 SW 117TH AVENUE, MIAMI, FL, 33183, US |
| ZIP code: | 33183 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134293491 | 2006-11-20 | 2024-09-20 | 714 W MLK BLVD STE A, TAMPA, FL, 336033104, US | 714 W MLK JR BLVD, TAMPA, FL, 33603, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 813-223-6222 |
| Fax | 8132236020 |
Authorized person
| Name | DR. STEPHEN A WILLIAMS |
| Role | DOCTOR |
| Phone | 8132236222 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | FLME0070792 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 379844500 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| WALTER JOSEPH | Vice President | 1515 SUNSET DRIVE, MIAMI, FL, 33143 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES | 2023-09-22 | No data | No data |
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 2023-09-22 | STEPHEN A. WILLIAMS, M.D., INC. | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
