1013823103 NPI number — MICHAEL T. MCCORMICK & ASSOCIATES PA

Table of content: (NPI 1013823103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013823103 NPI number — MICHAEL T. MCCORMICK & ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL T. MCCORMICK & ASSOCIATES PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013823103
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 825159
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-5159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
836 SUNSET LAKE BLVD STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VENICE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34292-7556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-493-8666
Provider Business Practice Location Address Fax Number:
941-497-5411
Provider Enumeration Date:
08/20/2026

Additional Information

Authorized Official

Authorized Official Last Name:
LAIRD
Authorized Official First Name:
ROY
Authorized Official Middle Name:
CLINT
Authorized Official Title or Position:
AUTHORIZED OWNER
Authorized Official Telephone Number:
941-493-8666

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com