=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316883481
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHAMON VANDRELL WILLIAMS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2026
-----------------------------------------------------
Last Update Date | 04/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4000 SW 37TH ST LOT I12
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32608-2312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-792-7877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4000 SW 37TH ST LOT I12
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32608-2312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-792-7877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number | DOULIO-CTAC-C326403
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------