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Individual

PHOEBE WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4006 E REGNAS AVE, TAMPA, FL 33617-6830
(813) 751-6817
(813) 899-0420
Mailing address
4006 E REGNAS AVE, TAMPA, FL 33617-6830
(813) 751-6817
(813) 899-0420

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6905166
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141498400
FL
Enumeration date
07/03/2014
Last updated
07/03/2014
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