Provider Demographics
NPI:1306972070
Name:VARNADORE, WILLIAM E JR (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:VARNADORE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:307 VENTANA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-4506
Mailing Address - Country:US
Mailing Address - Phone:850-231-3165
Mailing Address - Fax:
Practice Address - Street 1:82 SOUTH BARRETT SQUARE
Practice Address - Street 2:SUITE 2F
Practice Address - City:ROSEMARY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32461-1000
Practice Address - Country:US
Practice Address - Phone:850-231-3165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5513207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE57702Medicare UPIN