Basic Information
| Provider Information | |||||||||
| NPI: | 1265828180 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCCORMICK SHOULDER AND SPORTS SURGICAL SPECIALISTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2536 SE 9TH ST | ||||||||
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| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330626709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178035832 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2536 SE 9TH ST | ||||||||
| Address2: | |||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330626709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178035832 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2015 | ||||||||
| LastUpdateDate: | 01/05/2016 | ||||||||
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| AuthorizedOfficialLastName: | MCCORMICK | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
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| AuthorizedOfficialTitleorPosition: | ORTHOPEDIC SURGEON | ||||||||
| AuthorizedOfficialTelephone: | 6178035832 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | ME116967 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.