Basic Information
| Provider Information | |||||||||
| NPI: | 1205263266 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TATE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | LEMASTER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3745 NW MEDITERRANEAN LN | ||||||||
| Address2: | |||||||||
| City: | JENSEN BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349573108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7723359600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 200 AVENUE F NE | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338814131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6329311918 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2013 | ||||||||
| LastUpdateDate: | 11/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | UO 3474 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2969 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | ET-00369 | KS | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | OS13306 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | ET-00369 | KS | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.