Organization
DAVID A MACKOUL, M.D., P.A.
Active
Other names
MacKoul Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MACKOUL MD (PRESIDENT)
(239) 573-2001
Entity
Organization
Contact information
Practice address
206 SE 16TH PL, CAPE CORAL, FL 33990-1329
(239) 829-1747
(239) 573-2006
Mailing address
206 SE 16TH PL, CAPE CORAL, FL 33990-1329
(239) 829-1747
(239) 573-2006
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258711400
—
FL
05
—
258711402
—
FL
Enumeration date
08/03/2006
Last updated
11/08/2010
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