Willoughby C. Williams, LLC, D.B.a.-Disrict Medical Center

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

WILLOUGHBY C. WILLIAMS, LLC, D.B.A.-DISRICT MEDICAL CENTER

Practice address

1175 NE 125TH St
Suite 310
North Miami, FL 33161-5015

Phone

(305) 454-7656

Fax

(305) 365-3698

NPI assigned

Nov 12, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Geraldine Tisdol-Clark

Title

Manager

Phone

(305) 467-1989

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1629407655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 NE 125TH ST",
            "address_2": "SUITE 310",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615015",
            "telephone_number": "305-454-7656",
            "fax_number": "305-365-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 NE 125TH ST",
            "address_2": "SUITE 310",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615015",
            "telephone_number": "305-454-7656",
            "fax_number": "305-365-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOUGHBY C. WILLIAMS, LLC, D.B.A.-DISRICT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "TISDOL-CLARK",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-467-1989"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Jill Wilensky Rotbart, SLP
• William David Kirsh DO PA
• Alexandra Kelly Williams, PT, DPT
• Jinia Williams
• Kayla Cosette Williams, PT
• Brenna Cage Wilmott, LCSW
• Jerry Wimberly
• Joseph Christopher Wimpey, PHARM.D
• Kathryn Nicole Winston, MPT
• Amery Wirtshafter, MD

• Speech-Language Pathologist in North Miami, FL
• Providers in North Miami, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.