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General NPI Number Information
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NPI Number | 1205263266
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Entity Type | Individual
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Provider Name | WILLIAM LEMASTER TATE D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 200 AVENUE F NE
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4131
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Country | US
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Telephone | 632-931-1918
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Fax |
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Provider Business Mailing Address
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Address Line | 3745 NW MEDITERRANEAN LN
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City | JENSEN BEACH
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State | FL
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Zip | 34957-3108
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Country | US
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Telephone | 772-335-9600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2969
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | UO 3474
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS13306
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 05-46627
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License Number State | KS
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