=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093736597
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERICKA CHANTISA WILLIAMS-HAYE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2006
-----------------------------------------------------
Last Update Date | 12/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8950 N KENDALL DR STE 504W
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-2127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-595-0575
-----------------------------------------------------
Fax | 786-591-6186
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 198054
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30384-8054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-662-7980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA3750
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------