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General NPI Number Information
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NPI Number | 1265146609
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Entity Type | Organization
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Legal Business Name | SOUTHEAST INSTITUTE FOR OPTIMAL HEALTH
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 82 S BARRETT SQ STE 2F
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City | ROSEMARY BEACH
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State | FL
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Zip | 32461-6930
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Country | US
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Telephone | 850-231-3165
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 611057
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City | ROSEMARY BEACH
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State | FL
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Zip | 32461-1000
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Country | US
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Telephone | 850-231-3165
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Fax |
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. WILLIAM EDWARD VARNADORE JR.
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Credential | DO
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Telephone | 850-231-3165
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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 |
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License Number State |
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