Individual
SERENA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 WATER ST # B1414, TAMPA, FL 33602-5412
(813) 404-4229
Mailing address
815 WATER ST # B1414, TAMPA, FL 33602-5412
(813) 404-4229
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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