MEDICARE: WILLIAM ROYALL LCSW

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	1041C0700X	Clinical Social Worker	SW5156	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1013902956	OTHER	FL	NPI GROUP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083731863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ROYALL LCSW

Provider Business Mailing Address
First Line	:	6601 MEMORIAL HWY
Second Line	:	SUITE 107
City	:	TAMPA
State	:	FL
Zip	:	33615-4501
Country	:	US
Telephone Number	:	813-433-1987
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 MEMORIAL HWY
Second Line	:	SUITE 107
City	:	TAMPA
State	:	FL
Zip	:	33615-4501
Country	:	US
Telephone Number	:	813-433-1987
Fax Number	:

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

Provider Enumeration Date	:	03/25/2007
Last Update Date	:	01/17/2014

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