Provider Demographics
NPI:1497721252
Name:LAYDEN, WILLIAM E (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:LAYDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 83RD ST
Mailing Address - Street 2:
Mailing Address - City:HOLMES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34217-1021
Mailing Address - Country:US
Mailing Address - Phone:813-505-0080
Mailing Address - Fax:
Practice Address - Street 1:501 N HOWARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1213
Practice Address - Country:US
Practice Address - Phone:727-581-8706
Practice Address - Fax:727-588-2447
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0019275174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058060100Medicaid
FL593092491OtherTAX I.D. NUMBER
FL593092491OtherTAX I.D. NUMBER
FLD53707Medicare UPIN
FL058060100Medicaid