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General NPI Number Information
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NPI Number | 1730439670
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Entity Type | Organization
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Legal Business Name | BRIAN E. MCCARTHY, DPM,PA
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 06/08/2013
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Provider Practice Location Address
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Address Line | 11349 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-597-0049
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Fax | 352-597-4333
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Provider Business Mailing Address
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Address Line | 11349 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-597-0049
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Fax | 352-597-4333
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN MCCARTHY
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Credential | DPM
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Telephone | 352-597-0049
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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 | PO2296
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License Number State | FL
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