Provider Demographics
NPI:1568491264
Name:MCCLOSKEY, VERONICA (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 NW 117TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1213
Mailing Address - Country:US
Mailing Address - Phone:954-514-9360
Mailing Address - Fax:
Practice Address - Street 1:9725 NW 117TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33178-1213
Practice Address - Country:US
Practice Address - Phone:954-514-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111989207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004565000Medicaid
ME111989OtherMEDICAL LICENSE