Provider Demographics
NPI:1154615425
Name:WILLIAMS, NATALINE R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATALINE
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11627 W HILLSBOROUGH AVE
Mailing Address - Street 2:T-2289
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-9736
Mailing Address - Country:US
Mailing Address - Phone:813-749-5962
Mailing Address - Fax:813-749-5972
Practice Address - Street 1:11627 W HILLSBOROUGH AVE
Practice Address - Street 2:T-2289
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9736
Practice Address - Country:US
Practice Address - Phone:813-749-5962
Practice Address - Fax:813-749-5972
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist