Provider Demographics
NPI:1558858837
Name:WASHINGTON, TAMEKA LATOYA
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:LATOYA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NE 123RD ST STE 409
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2884
Mailing Address - Country:US
Mailing Address - Phone:786-216-7803
Mailing Address - Fax:888-946-3938
Practice Address - Street 1:1801 NE 123RD ST STE 409
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2884
Practice Address - Country:US
Practice Address - Phone:786-216-7803
Practice Address - Fax:888-946-3938
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-22
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9460253363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner