Provider Demographics
NPI:1972714384
Name:MCD MEDICAL CORP
Entity Type:Organization
Organization Name:MCD MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIVIO
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAGUARDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-825-2303
Mailing Address - Street 1:10550 NW 77TH CT
Mailing Address - Street 2:SUITE 224
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-7084
Mailing Address - Country:US
Mailing Address - Phone:305-825-2303
Mailing Address - Fax:
Practice Address - Street 1:10550 NW 77TH CT
Practice Address - Street 2:SUITE 224
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-7084
Practice Address - Country:US
Practice Address - Phone:305-825-2303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty