MEDICARE: DR. WILLIAM ROBERT LA ROSA III M.D.

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	207Q00000X	Family Medicine Physician	56120	AZ

General Provider Information

NPI Number	:	1710372651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ROBERT LA ROSA III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 24981
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-2000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301 E 2ND ST STE 210
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251
Country	:	US
Telephone Number	:	480-882-4545
Fax Number	:

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

Provider Enumeration Date	:	03/30/2015
Last Update Date	:	04/21/2026

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