Provider Demographics
NPI:1750509303
Name:MCGINN, MICHAEL THOMAS (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:MCGINN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:MCGINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8745 SW 56TH PL
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5917
Mailing Address - Country:US
Mailing Address - Phone:865-406-3668
Mailing Address - Fax:305-642-2320
Practice Address - Street 1:3095 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4241
Practice Address - Country:US
Practice Address - Phone:305-642-4044
Practice Address - Fax:305-642-2320
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3477213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist