Provider Demographics
NPI:1073518445
Name:ZINK, WILLIAM PIROTTE (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PIROTTE
Last Name:ZINK
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 1:2909 N. ORANGE AVE.
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4639
Mailing Address - Country:US
Mailing Address - Phone:407-894-0088
Mailing Address - Fax:407-895-6790
Practice Address - Street 1:2909 N. ORANGE AVE.
Practice Address - Street 2:SUITE 102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4639
Practice Address - Country:US
Practice Address - Phone:407-894-0088
Practice Address - Fax:407-895-6790
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2011-10-17
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
FLME0042279174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47564OtherBS
FL069373100Medicaid
FL47564OtherBS