Provider Demographics
NPI:1669749370
Name:MCCORMICK, DAVID CRAIG (PHARMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CRAIG
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 CORPORATE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3504
Mailing Address - Country:US
Mailing Address - Phone:954-385-7322
Mailing Address - Fax:954-385-7324
Practice Address - Street 1:3300 CORPORATE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3504
Practice Address - Country:US
Practice Address - Phone:954-385-7322
Practice Address - Fax:954-385-7324
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS191951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist