Provider Demographics
NPI:1942307491
Name:MCCARTY C.R.N.A., INC.
Entity Type:Organization
Organization Name:MCCARTY C.R.N.A., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:352-377-7733
Mailing Address - Street 1:4131 N.W. 13TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-1858
Mailing Address - Country:US
Mailing Address - Phone:352-376-1887
Mailing Address - Fax:352-375-7451
Practice Address - Street 1:2521 NW 41ST STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6630
Practice Address - Country:US
Practice Address - Phone:352-377-7733
Practice Address - Fax:352-377-9577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1100OtherBCBS
G1100Medicare ID - Type Unspecified