Individual
TASSCIA M WILLIAMS SOUFFRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
61 THOMAS JOHNSON DR, FREDERICK, MD 21702-4301
(301) 663-6171
(301) 695-4469
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5615
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D85692
MD
207V00000X
Obstetrics & Gynecology Physician
MD458253
PA
207V00000X
Obstetrics & Gynecology Physician
Primary
ME149269
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D85692
STATE LICENSE
MD
01
—
PENDING
MEDICARE HF
FL
05
—
PENDING
—
FL
Enumeration date
09/21/2011
Last updated
03/07/2023
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