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General NPI Number Information
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NPI Number | 1376036269
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Entity Type | Individual
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Provider Name | DR. JOHN THOMAS SERBES MCCAIN
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 1233 SE INDIAN ST STE 102
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City | STUART
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State | FL
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Zip | 34997-5689
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Country | US
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Telephone | 772-223-8313
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Fax | 772-223-8675
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Provider Business Mailing Address
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Address Line | 1233 SE INDIAN ST STE 102
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City | STUART
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State | FL
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Zip | 34997-5689
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 135.001019
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License Number State | IL
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