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General NPI Number Information
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NPI Number | 1104375641
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Entity Type | Individual
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Provider Name | RACINE WILLIAMS BSN
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Gender | Female
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 11300 NE 2ND AVE
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City | MIAMI SHORES
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State | FL
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Zip | 33161-6628
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Country | US
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Telephone | 954-397-5012
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Fax |
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Provider Business Mailing Address
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Address Line | 4551 TARA COVE WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-3004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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License Number | RN9491826
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9491826
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License Number State | FL
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