Healthcare Provider Details

I. General information

NPI: 1942936893
Provider Name (Legal Business Name): NASTASSIA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W KENNEDY BLVD STE 160
TAMPA FL
33609-1817
US

IV. Provider business mailing address

10250 SW 56TH ST STE A202
MIAMI FL
33165-7095
US

V. Phone/Fax

Practice location:
  • Phone: 888-527-8037
  • Fax:
Mailing address:
  • Phone: 888-527-8037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0-18-9034
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-18-9034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: