Provider Demographics
NPI:1164587978
Name:UNGUREIT, WILLIAM R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:UNGUREIT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:13535 NEMOURS PKWY
Mailing Address - Street 2:DEPARTMENT OF ORTHOPAEDIC SURGERY
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7402
Mailing Address - Country:US
Mailing Address - Phone:407-567-3859
Mailing Address - Fax:407-567-3880
Practice Address - Street 1:13535 NEMOURS PKWY
Practice Address - Street 2:DEPARTMENT OF ORTHOPAEDIC SURGERY
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7402
Practice Address - Country:US
Practice Address - Phone:407-567-3859
Practice Address - Fax:407-567-3880
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2012-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL9104095363AS0400X
FLPA9104095363AS0400X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL293009900Medicaid