Provider Demographics
NPI:1548573785
Name:KING, WILLIAM V
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:V
Last Name:KING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S PARK RD
Mailing Address - Street 2:APT. 108
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8726
Mailing Address - Country:US
Mailing Address - Phone:786-718-0416
Mailing Address - Fax:
Practice Address - Street 1:3500 N STATE ROAD 7
Practice Address - Street 2:SUITE 212
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5600
Practice Address - Country:US
Practice Address - Phone:954-578-8399
Practice Address - Fax:954-578-0145
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health