Provider Demographics
NPI:1043202245
Name:ASSAD, WILLIAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:ASSAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18002
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-8002
Mailing Address - Country:US
Mailing Address - Phone:813-353-8803
Mailing Address - Fax:813-353-8602
Practice Address - Street 1:601 S ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4123
Practice Address - Country:US
Practice Address - Phone:813-353-8803
Practice Address - Fax:813-353-8602
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00487222085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4048015OtherAETNA
FL044496100Medicaid
FL02112OtherBCBS
A62989Medicare UPIN
FL02112OtherBCBS