Healthcare Provider Details

I. General information

NPI: 1396932364
Provider Name (Legal Business Name): WILLIAM A DOWNES M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22945 STATE ROAD 54
LUTZ FL
33549-6900
US

IV. Provider business mailing address

6736 SUMMER HAVEN DR
RIVERVIEW FL
33578-8971
US

V. Phone/Fax

Practice location:
  • Phone: 813-909-1822
  • Fax:
Mailing address:
  • Phone: 813-546-9896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME98640
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: