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General NPI Number Information
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NPI Number | 1184040891
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Entity Type | Individual
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Provider Name | SANDRELL WILLIAMS ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 6800 N DALE MABRY HWY STE 186
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City | TAMPA
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State | FL
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Zip | 33614-3998
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Country | US
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Telephone | 813-839-3438
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Fax |
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Provider Business Mailing Address
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Address Line | 4313 S FLORIDA AVE # 1005
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City | LAKELAND
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State | FL
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Zip | 33813-1654
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Country | US
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Telephone | 863-457-4919
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9281116
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License Number State | FL
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