Provider Demographics
NPI:1083650030
Name:HANDELMAN, WILLIAM NATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:NATHAN
Last Name:HANDELMAN
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 1:6399 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710
Mailing Address - Country:US
Mailing Address - Phone:727-384-6411
Mailing Address - Fax:
Practice Address - Street 1:6399 38TH AVE N
Practice Address - Street 2:SUITE C6
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1647
Practice Address - Country:US
Practice Address - Phone:727-384-6411
Practice Address - Fax:727-384-9033
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME069462207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28213OtherBCBS
FL379934400Medicaid
FL28213OtherBCBS
FL28213ZMedicare PIN