Provider Demographics
NPI:1962837385
Name:BROOME, WILLIAM LONAS (SPECIALIST)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LONAS
Last Name:BROOME
Suffix:
Gender:M
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1578 BELLA CRUZ DR
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8969
Mailing Address - Country:US
Mailing Address - Phone:352-750-2005
Mailing Address - Fax:352-750-2055
Practice Address - Street 1:1578 BELLA CRUZ DR
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8969
Practice Address - Country:US
Practice Address - Phone:352-750-2005
Practice Address - Fax:352-750-2055
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2768237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist