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NPI 1205193752

NPI 1205193752 : JAMES J. MACOOL, MD, PA : ALTAMONTE SPRINGS, FL

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General NPI Number Information
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    NPI Number           |    1205193752
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    Entity Type          |    Organization 
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    Legal Business Name  |    JAMES J. MACOOL, MD, PA 
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Dates
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    Enumeration Date     |    04/20/2012
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    Last Update Date     |    03/27/2013
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Provider Practice Location Address
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    Address Line         |    765 DOUGLAS AVE 
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    City                 |    ALTAMONTE SPRINGS
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    State                |    FL
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    Zip                  |    32714-2566
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    Country              |    US
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    Telephone            |    407-774-7781
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2980 N BEVERLY GLEN CIR SUITE 301
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90077-1726
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    Country              |    US
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    Telephone            |    310-474-9809
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. JAMES J. MACOOL 
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    Credential           |    MD
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    Telephone            |    407-774-7781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332900000X
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    Taxonomy Name        |    Non-Pharmacy Dispensing Site
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    License Number       |    
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    License Number State |    
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