Provider Demographics
NPI:1831135060
Name:MCCUE, JOHN (ARNP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:MCCUE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13300 S CLEVELAND AVE
Mailing Address - Street 2:56 206
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3886
Mailing Address - Country:US
Mailing Address - Phone:239-292-3871
Mailing Address - Fax:
Practice Address - Street 1:13300 S CLEVELAND AVE
Practice Address - Street 2:56 206
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3886
Practice Address - Country:US
Practice Address - Phone:239-292-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9205590363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9205590OtherNURSE PRACTITIONER