DR. JENNIFER MICHELLE WILLIS MD NPI 1063675106

NPI Information

  • NPI: 1063675106
  • Provider Name: DR. JENNIFER MICHELLE WILLIS, MD
  • Classification: Pediatrics - 2080P0210X
  • Specialization: Pediatric Nephrology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 615 E PRINCETON ST STE 401
    ORLANDO, FL
    ZIP 32803
  • Phone: (407) 303-9311

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NPI Details

DR. Jennifer Michelle Willis, MD is a pediatric nephrology pediatrics in Orlando, FL with 21 years of experience. The provider is a pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. DR. Jennifer Michelle Willis, MD NPI is 1063675106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

615 E PRINCETON ST STE 401
ORLANDO, FL
ZIP 32803-469
Phone: (407) 303-9311
Fax: (407) 303-9273

The NPI 1063675106 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2008 and was last updated on 9/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsME141361FLORIDANo
22080P0210XPediatricsPediatric NephrologyQ2152TEXASNo
32080P0210XPediatricsPediatric Nephrology036 121316ILLINOISNo
42080P0210XPediatricsPediatric NephrologyME141361FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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