Provider Demographics
NPI:1265472864
Name:MORGAN, WILLIAM ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ROBERT
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 TAMIAMI TRL S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-4133
Mailing Address - Country:US
Mailing Address - Phone:941-480-2831
Mailing Address - Fax:941-485-8062
Practice Address - Street 1:333 MIAMI AVE W
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2361
Practice Address - Country:US
Practice Address - Phone:941-484-4778
Practice Address - Fax:941-485-8062
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0062802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5618710OtherFIRST HEALTH
FL201841070OtherTAX ID FOR GCMG
FL38609OtherBLUE CROSS BLUE SHIELD
5618710OtherFIRST HEALTH