Provider Demographics
NPI:1992782197
Name:NORDIN, WILLIAM THOMAS (ARNP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:NORDIN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W WINTER PARK ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4903
Mailing Address - Country:US
Mailing Address - Phone:407-849-6359
Mailing Address - Fax:
Practice Address - Street 1:801 W WINTER PARK ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4903
Practice Address - Country:US
Practice Address - Phone:407-849-6359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3101922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305850600Medicaid
FLS66043Medicare UPIN
FL305850600Medicaid