Provider Demographics
NPI:1245564962
Name:HERRIOTT, WILLIAM PAUL (MMS, PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PAUL
Last Name:HERRIOTT
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Gender:M
Credentials:MMS, PA-C
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Mailing Address - Street 1:15051 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5182
Mailing Address - Country:US
Mailing Address - Phone:239-437-8810
Mailing Address - Fax:239-313-2555
Practice Address - Street 1:1108 GOODLETTE RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5451
Practice Address - Country:US
Practice Address - Phone:239-434-0303
Practice Address - Fax:239-262-8730
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2017-02-10
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Provider Licenses
StateLicense IDTaxonomies
FLPA9110027363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant