Provider Demographics
NPI:1871070110
Name:WILLIAMS, SONYA (CNA)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 PRUDENTIAL DRIVE, SUITE 1200
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207
Mailing Address - Country:US
Mailing Address - Phone:866-688-7588
Mailing Address - Fax:800-261-7083
Practice Address - Street 1:841 PRUDENTIAL DRIVE, SUITE 1200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:866-688-7588
Practice Address - Fax:800-261-7083
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2023-04-09
Deactivation Date:2018-10-10
Deactivation Code:
Reactivation Date:2023-04-06
Provider Licenses
StateLicense IDTaxonomies
FL358752376K00000X
FLCNA358752253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No376K00000XNursing Service Related ProvidersNurse's Aide