Provider Demographics
NPI:1306840673
Name:BELMONT, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:BELMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:S
Other - Last Name:BELMONT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1219 EAST AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2340
Mailing Address - Country:US
Mailing Address - Phone:941-957-4216
Mailing Address - Fax:
Practice Address - Street 1:1219 EAST AVENUE
Practice Address - Street 2:STE 105
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236
Practice Address - Country:US
Practice Address - Phone:941-957-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12016207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56862Medicare UPIN
FL58165ZMedicare ID - Type Unspecified