Provider Demographics
NPI:1790761724
Name:COONEY, WILLIAM P III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:COONEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 HOLLY RD
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-1454
Practice Address - Country:US
Practice Address - Phone:507-254-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91212207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF120ZOtherMEDICARE
FLP00462899OtherMEDICARE RR
FL020169000Medicaid
MN091017100Medicaid
FL6194400001OtherPALMETTO
FL53629OtherBLUE CROSS BLUE SHEILD FL
FLAF120ZOtherMEDICARE
MN200005201Medicare ID - Type UnspecifiedRAILROAD
MN400000018Medicare ID - Type Unspecified
FLP00462899OtherMEDICARE RR