MEDICARE: WILLIAM LAURENTE CUA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME63065	FL

General Provider Information

NPI Number	:	1679583751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM LAURENTE CUA MD

Provider Business Mailing Address
First Line	:	555 RANCH RD
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-9027
Country	:	US
Telephone Number	:	727-848-2444
Fax Number	:	727-817-1577

Provider Business Practice Location Address
First Line	:	555 RANCH RD
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-9027
Country	:	US
Telephone Number	:	727-848-2444
Fax Number	:	727-817-1577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	04/13/2012

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