Individual
JORGE MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 6TH AVE S STE 120, ST PETERSBURG, FL 33701
(727) 322-4830
Mailing address
625 6TH AVE S STE 120, ST PETERSBURG, FL 33701-4654
(727) 322-4830
(954) 858-0404
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
45851
FL
2080P0202X
Pediatric Cardiology Physician
Primary
45851
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371512400
—
FL
Enumeration date
05/31/2006
Last updated
06/19/2018
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