MEDICARE: SANEICKA MCCOOK

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	363L00000X	Nurse Practitioner	APRN11010339	FL

General Provider Information

NPI Number	:	1912570516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANEICKA MCCOOK

Provider Business Mailing Address
First Line	:	14392 WARD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-7837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14392 WARD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-7837
Country	:	US
Telephone Number	:	347-376-3842
Fax Number	:

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

Provider Enumeration Date	:	07/21/2021
Last Update Date	:	07/21/2021

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Directions to “ SANEICKA MCCOOK ” Practice Location

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