Healthcare Provider Details

I. General information

NPI: 1093736597
Provider Name (Legal Business Name): ERICKA CHANTISA WILLIAMS-HAYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 504W
MIAMI FL
33176-2127
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-595-0575
  • Fax: 786-591-6186
Mailing address:
  • Phone: 786-662-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: