MEDICARE: WILLIAM VINCENT BURKE MD

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	207X00000X	Orthopaedic Surgery Physician	ME75019	FL
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	ME75019	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	44994	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1407811524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM VINCENT BURKE MD

Provider Business Mailing Address
First Line	:	2307 W BROWARD BLVD
Second Line	:	STE 200
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1417
Country	:	US
Telephone Number	:	954-792-1010
Fax Number	:	954-792-1199

Provider Business Practice Location Address
First Line	:	2307 W BROWARD BLVD
Second Line	:	STE 200
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1417
Country	:	US
Telephone Number	:	954-792-1010
Fax Number	:	954-792-1199

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	02/15/2016

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