Healthcare Provider Details

I. General information

NPI: 1104646157
Provider Name (Legal Business Name): WILLIAM ANTHONY REES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 TURKEY LAKE RD STE 114
ORLANDO FL
32819-4205
US

IV. Provider business mailing address

10357 FALCON PARC BLVD
ORLANDO FL
32832-5539
US

V. Phone/Fax

Practice location:
  • Phone: 321-732-3723
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT24379720
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: