Provider Demographics
NPI:1700085735
Name:WILLIAM P COONEY III MD PA
Entity Type:Organization
Organization Name:WILLIAM P COONEY III MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:772-978-7808
Mailing Address - Street 1:1355 37TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7321
Mailing Address - Country:US
Mailing Address - Phone:772-978-7808
Mailing Address - Fax:772-978-9320
Practice Address - Street 1:1355 37TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7321
Practice Address - Country:US
Practice Address - Phone:772-978-7808
Practice Address - Fax:772-978-9320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 91212207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00462899OtherRR MEDICARE P TAN
DG9256OtherRR MEDICARE GROUP
DG9256OtherRR MEDICARE GROUP