Individual
MARY YVONNE MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
820 PRUDENTIAL DR, SUITE 416, JACKSONVILLE, FL 32207-8210
(904) 202-1152
(904) 202-1152
Mailing address
820 PRUDENTIAL DR STE 416, JACKSONVILLE, FL 32207-8206
(904) 202-1152
(904) 202-2462
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 1658
FL
Other
Enumeration date
12/11/2009
Last updated
12/11/2009
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