Provider Demographics
NPI:1245706050
Name:WILLIAMS, TIQUANA (CD(DONA))
Entity type:Individual
Prefix:MRS
First Name:TIQUANA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 SW 64TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3841
Mailing Address - Country:US
Mailing Address - Phone:954-394-1536
Mailing Address - Fax:
Practice Address - Street 1:3261 SW 64TH TER
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3841
Practice Address - Country:US
Practice Address - Phone:954-394-1536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12444374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula