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General NPI Number Information
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NPI Number | 1376207340
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Entity Type | Individual
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Provider Name | TARA WILLIAMS DNP, RN
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Gender | Female
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 10360 CITY CENTER BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-4488
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Country | US
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Telephone | 267-663-8354
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Fax |
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Provider Business Mailing Address
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Address Line | 16000 PINES BLVD UNIT 822701
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City | PEMBROKE PINES
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State | FL
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Zip | 33082-9270
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Country | US
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Telephone | 267-663-8354
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 9447460
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 9447460
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 9447460
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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