Provider Demographics
NPI:1083459432
Name:MCCLURE, WILLIAM DOUGLAS II
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DOUGLAS
Last Name:MCCLURE
Suffix:II
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13205 SW 137TH AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5335
Mailing Address - Country:US
Mailing Address - Phone:786-732-6298
Mailing Address - Fax:
Practice Address - Street 1:13205 SW 137TH AVE STE 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5335
Practice Address - Country:US
Practice Address - Phone:786-732-6298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-24-369833106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician