MEDICARE: TONYA LORISE WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2472R0900X	Renal Dialysis Technician	9646819	FL

General Provider Information

NPI Number	:	1144187477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA LORISE WILLIAMS

Provider Business Mailing Address
First Line	:	3118 POINCIANA ST
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1192
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3118 POINCIANA ST
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1192
Country	:	US
Telephone Number	:	334-294-3938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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