Healthcare Provider Details

I. General information

NPI: 1609181528
Provider Name (Legal Business Name): JAMES J. MACOOL, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 DOUGLAS AVE
ALTAMONTE SPRINGS FL
32714-2566
US

IV. Provider business mailing address

765 DOUGLAS AVE
ALTAMONTE SPRINGS FL
32714-2566
US

V. Phone/Fax

Practice location:
  • Phone: 407-774-7781
  • Fax: 407-774-7743
Mailing address:
  • Phone: 407-774-7781
  • Fax: 407-774-7743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0030738
License Number StateFL

VIII. Authorized Official

Name: MR. JAMES J MACOOL
Title or Position: OWNER
Credential: M.D.
Phone: 407-774-7781