Provider Demographics
NPI:1023062387
Name:QUARTUCCIO, WILLIAM JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:QUARTUCCIO
Suffix:
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 1:18946 DUQUESNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647
Mailing Address - Country:US
Mailing Address - Phone:813-866-4162
Mailing Address - Fax:
Practice Address - Street 1:2 COLUMBIA DR
Practice Address - Street 2:SUITE: A-327
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3508
Practice Address - Country:US
Practice Address - Phone:813-844-4396
Practice Address - Fax:813-844-4972
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059107A207L00000X
FLME58297207L00000X
KY40997207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN343594OtherBCBS/ANTHEM
FL23622OtherFL BCBS NUMBER
FL23622OtherFL BCBS NUMBER
IN343594OtherBCBS/ANTHEM
FLF71777Medicare UPIN
IN233090Medicare ID - Type UnspecifiedIN FGTBA MEDICARE
FL23622AMedicare ID - Type UnspecifiedGTBA MEDICARE
IN233090FMedicare ID - Type UnspecifiedIN MEDICARE