Provider Demographics
NPI:1972561553
Name:REUTHER, WARREN LOUIS III (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:LOUIS
Last Name:REUTHER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5555 ANGLERS AVENUE SUITE 24
Mailing Address - Street 2:FLORIDA UNITED RADIOLOGY
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312
Mailing Address - Country:US
Mailing Address - Phone:954-962-6265
Mailing Address - Fax:954-893-9595
Practice Address - Street 1:2201 N 45 STREET
Practice Address - Street 2:COLUMBIA HOSPITAL
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-863-3970
Practice Address - Fax:561-863-2527
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME887662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G98941Medicare UPIN
FL37663Medicare ID - Type Unspecified