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NPI Code Detail

MEDICARE: MS. MAIRE BRIGID MCCORMACK RPT

MEDICARE:  MS. MAIRE BRIGID MCCORMACK  RPT
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
1225100000XPhysical TherapistPT9098FL

General Provider Information

NPI Number : 1518097781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAIRE BRIGID MCCORMACK RPT
Provider Business Mailing Address
First Line : 1505 BEACH DR NE
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33704-4815
Country : US
Telephone Number : 727-821-2700
Fax Number :
Provider Business Practice Location Address
First Line : 1505 BEACH DR NE
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33704-4815
Country : US
Telephone Number : 727-821-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/09/2007

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Directions to “ MS. MAIRE BRIGID MCCORMACK RPT” Practice Location

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