Provider Demographics
NPI:1134871627
Name:TW EXECUTIVE CONSULTING FIRM
Entity type:Organization
Organization Name:TW EXECUTIVE CONSULTING FIRM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, RN, CCM
Authorized Official - Phone:305-339-8200
Mailing Address - Street 1:16000 PINES BLVD UNIT 822701
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-9270
Mailing Address - Country:US
Mailing Address - Phone:305-339-8200
Mailing Address - Fax:
Practice Address - Street 1:10360 CITY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4488
Practice Address - Country:US
Practice Address - Phone:305-339-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory