Provider Demographics
NPI:1326074246
Name:TOBACK, WILLIAM L (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:TOBACK
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:1651 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5903
Practice Address - Country:US
Practice Address - Phone:561-966-1000
Practice Address - Fax:561-432-0618
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5526207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80121Medicare UPIN
FLF05526Medicare UPIN