MEDICARE: DAVID MCKITRICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	22924369	FL

General Provider Information

NPI Number	:	1407389299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MCKITRICK

Provider Business Mailing Address
First Line	:	5006 TROUBLE CREEK RD
Second Line	:	STE 104
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4922
Country	:	US
Telephone Number	:	727-286-3176
Fax Number	:	727-286-3177

Provider Business Practice Location Address
First Line	:	5006 TROUBLE CREEK RD
Second Line	:	STE 104
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4922
Country	:	US
Telephone Number	:	727-286-3176
Fax Number	:	727-286-3177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2017
Last Update Date	:	04/07/2017

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Directions to “ DAVID MCKITRICK ” Practice Location

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