Provider Demographics
NPI:1598037442
Name:MCCARTHY, THOMAS PATRICK (LMT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PATRICK
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E OLYMPIA AVENUE SUITE 309
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950
Mailing Address - Country:US
Mailing Address - Phone:941-416-2718
Mailing Address - Fax:
Practice Address - Street 1:109 E OLYMPIA AVE UNIT 309
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3822
Practice Address - Country:US
Practice Address - Phone:941-416-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA51113225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist