Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Allan Willis, IDC

Individual provider Independent Duty Corpsman · NPI 1619420536

Justin Allan Willis, IDC is an Independent Duty Corpsman in Seminole, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2016
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Practice location Address checks out

8353 Iris Ave
Seminole, FL 33777-3643
Phone: (727) 288-4516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X · Licence W4204214450 (FL)

Record details

NPI number1619420536
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedJuly 27, 2016
Last updated in NPPESJuly 27, 2016

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