Healthcare Provider Details

I. General information

NPI: 1730910928
Provider Name (Legal Business Name): MONICA FAYE WILLIAMS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA FAYE YOUNG

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1858 ALTAVISTA CIR FL 5
LAKELAND FL
33810-2795
US

IV. Provider business mailing address

1858 ALTAVISTA CIR
LAKELAND FL
33810-2795
US

V. Phone/Fax

Practice location:
  • Phone: 863-777-3186
  • Fax:
Mailing address:
  • Phone: 863-680-7000
  • Fax: 866-264-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11034648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: