Provider Demographics
NPI:1922111046
Name:MCCARTHY, JOAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:M
Last Name:MCCARTHY
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 1:5 TAMPA GENERAL CIR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3601
Mailing Address - Country:US
Mailing Address - Phone:813-569-0740
Mailing Address - Fax:813-864-7603
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:SUITE 440
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-569-0740
Practice Address - Fax:813-864-7603
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79261207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58699OtherBLUE CROSS BLUE SHIELD
FL260858800Medicaid
FL58699OtherBLUE CROSS BLUE SHIELD
FL58699ZMedicare PIN