Provider Demographics
NPI:1124600937
Name:SHAWN WILLIAMS COLLECTION, LLC.
Entity Type:Organization
Organization Name:SHAWN WILLIAMS COLLECTION, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LPC
Authorized Official - Phone:813-603-8426
Mailing Address - Street 1:10201 CYPRESS LINKS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3195
Mailing Address - Country:US
Mailing Address - Phone:813-603-8426
Mailing Address - Fax:813-212-7637
Practice Address - Street 1:15241 AMBERLY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2155
Practice Address - Country:US
Practice Address - Phone:813-603-8426
Practice Address - Fax:813-212-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment