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NPI Code Detail

MEDICARE: WILLIAM X FINCKE P.A.

MEDICARE: WILLIAM X FINCKE P.A.
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
1363AS0400XSurgical Physician AssistantPA3245FL

General Provider Information

NPI Number : 1578623070
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM X FINCKE P.A.
Provider Business Mailing Address
First Line : 9904 PAVAROTTI TER
Second Line : #103
City : BOYNTON BEACH
State : FL
Zip : 33437-3372
Country : US
Telephone Number : 561-740-0202
Fax Number :
Provider Business Practice Location Address
First Line : 9904 PAVAROTTI TER
Second Line : #103
City : BOYNTON BEACH
State : FL
Zip : 33437-3372
Country : US
Telephone Number : 561-740-0202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 12/08/2011

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