Healthcare Provider Details

I. General information

NPI: 1225828221
Provider Name (Legal Business Name): REBECCA MCCORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-4511
US

IV. Provider business mailing address

1550 S WATER ST
STARKE FL
32091-4511
US

V. Phone/Fax

Practice location:
  • Phone: 352-392-4541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN1103945
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11039405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: