MEDICARE: SONYA C WILLIAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	6905677	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619300498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA C WILLIAMS

Provider Business Mailing Address
First Line	:	501 N FREMONT AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-1236
Country	:	US
Telephone Number	:	813-254-7083
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 N FREMONT AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-1236
Country	:	US
Telephone Number	:	813-254-7083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2013
Last Update Date	:	08/15/2013

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Directions to “ SONYA C WILLIAMS ” Practice Location

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