Provider Demographics
NPI:1356344501
Name:CUBIDES, WILLIAM D (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:CUBIDES
Suffix:
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 1:1405 CREEK NINE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34286-8050
Mailing Address - Country:US
Mailing Address - Phone:941-525-7221
Mailing Address - Fax:941-240-8958
Practice Address - Street 1:1405 CREEK NINE DR
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286-8050
Practice Address - Country:US
Practice Address - Phone:941-525-7221
Practice Address - Fax:941-240-8958
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME45775207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62638OtherBCBS
FL62638OtherBCBS
FL62638DMedicare ID - Type Unspecified