Mark Steven Willner, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME52952 Issued in FL

Practice address

14201 W Sunrise Blvd
Suite 208
Sunrise, FL 33323-3207

Phone

(954) 851-9690

Fax

(954) 851-9688

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Avanti Wellness Center Flllp

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1215179056
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1831115674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 WINDMILL LAKES RD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333322107",
            "telephone_number": "954-851-9690",
            "fax_number": "954-851-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD",
            "address_2": "SUITE 208",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-851-9690",
            "fax_number": "954-851-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLNER",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME52952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terentia Imogene Williams
• Tiffany Eprell Williams
• Varron A Williams, DPT
• Jimmie Elliott Williamson, CRNA
• Diane Willis
• Edward Wills
• Courtney Jermaine Wilson, PHD, LCSW
• Holly Wilson, M.D.
• Kevin Anthony Wilson, DO
• Timothy R. Wilson, MD

• Psychiatry Physician in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.