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General NPI Number Information
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NPI Number | 1750079950
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Entity Type | Individual
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Provider Name | MAGGIE MCCORMICK
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 11300 NE 2ND AVE
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City | MIAMI SHORES
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State | FL
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Zip | 33161-6695
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Country | US
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Telephone | 973-830-0165
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Fax |
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Provider Business Mailing Address
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Address Line | 921 NW 85TH TER APT 1202
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City | PLANTATION
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State | FL
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Zip | 33324-1231
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Country | US
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Telephone | 973-830-0165
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00343600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL7533
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License Number State | FL
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