Healthcare Provider Details

I. General information

NPI: 1346593985
Provider Name (Legal Business Name): MELISSA WILLIAMS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 NW 107TH AVE STE 400
DORAL FL
33172-2215
US

IV. Provider business mailing address

3105 NW 107TH AVE STE 400
DORAL FL
33172-2215
US

V. Phone/Fax

Practice location:
  • Phone: 954-324-7650
  • Fax: 305-703-2202
Mailing address:
  • Phone: 631-960-2459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11045872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: