MEDICARE: BRENDA MARIE WILLIAMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	372500000X	Chore Provider	FL
2	372600000X	Adult Companion	FL
3	3747A0650X	Attendant Care Provider	FL
4	3747P1801X	Personal Care Attendant	FL
5	376J00000X	Homemaker	FL
6	385H00000X	Respite Care	FL
7	385HR2050X	Respite Care Camp	FL
8	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care	FL

General Provider Information

NPI Number	:	1477329290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA MARIE WILLIAMS

Provider Business Mailing Address
First Line	:	2846 NW 9TH CT
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-6667
Country	:	US
Telephone Number	:	786-670-1068
Fax Number	:

Provider Business Practice Location Address
First Line	:	2846 NW 9TH CT
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-6667
Country	:	US
Telephone Number	:	786-670-1068
Fax Number	:

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

Provider Enumeration Date	:	12/01/2023
Last Update Date	:	12/01/2023

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