Male or Other

Michael S. Mcnulty PA

Medical Physician Assistant in Land O Lakes, FL(View on Map)

Full Name

Michael S Mcnulty PA

NPI Number

1811960099

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/09/2006

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Pennsylvania

License Number

MA0011803L

Contact
Information

Purpose

Mailing
Location

Address

22928 EAGLES WATCH DR
22928 EAGLES WATCH DR

City

Land O Lakes
Land O Lakes

State

FL
FL

Postal Code

34639-4787
34639-4787

Country

US
US

Telephone Number

(813) 929-0733
(813) 929-0733

Identifiers

Identifier

MA0011803L

Identifier State

PA

Identifier Issuer

LICENSE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/24/2016

Provider Address

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