Provider Demographics
NPI:1427025741
Name:MCFEE, PAUL ANTHONY (PAC MBA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ANTHONY
Last Name:MCFEE
Suffix:
Gender:M
Credentials:PAC MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 SIR LANCELOT CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7005
Mailing Address - Country:US
Mailing Address - Phone:407-399-9553
Mailing Address - Fax:
Practice Address - Street 1:1451 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-0041
Practice Address - Country:US
Practice Address - Phone:352-751-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-06
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2624363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291867600Medicaid
E4016DMedicare ID - Type Unspecified
P05012Medicare UPIN