Provider Demographics
NPI:1265765226
Name:WILLIAM S. MAXFIELD, M.D., LLC
Entity type:Organization
Organization Name:WILLIAM S. MAXFIELD, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAXFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-857-3864
Mailing Address - Street 1:8947 DONNA LU DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1908
Mailing Address - Country:US
Mailing Address - Phone:813-857-3864
Mailing Address - Fax:813-920-1755
Practice Address - Street 1:8947 DONNA LU DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-1908
Practice Address - Country:US
Practice Address - Phone:813-857-3864
Practice Address - Fax:813-920-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME152662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty