MEDICARE: PATRICK M MCGOOKEY MD PA

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	2084N0400X	Neurology Physician	ME0060048	FL

General Provider Information

NPI Number	:	1700121779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICK M MCGOOKEY MD PA

Provider Business Mailing Address
First Line	:	126 DEL PRADO BLVD N
Second Line	:	UNIT 106
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-2713
Country	:	US
Telephone Number	:	239-772-5066
Fax Number	:	239-772-4194

Provider Business Practice Location Address
First Line	:	126 DEL PRADO BLVD N
Second Line	:	UNIT 106
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-2713
Country	:	US
Telephone Number	:	239-772-5066
Fax Number	:	239-772-4194

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PATRICK M MCGOOKEY
Credential	:	M.D.
Telephone Number	:	239-772-5066

Provider Enumeration Date	:	12/03/2012
Last Update Date	:	05/08/2014

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