Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME75019 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME75019 | FL |
NPI | 1407811524 |
---|---|
Provider Name | William Vincent Burke |
First Address | Fort Lauderdale, FL 33312-1417 |
Second Address | Fort Lauderdale, FL 33312-1417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 15/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
263865700 | (05) | FL |
44994 | BCBS (01) | FL |
G86098 | (02) |