Individual
MICHAEL S MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
22928 EAGLES WATCH DR, LAND O LAKES, FL 34639-4787
(813) 929-0733
(813) 903-4812
Mailing address
22928 EAGLES WATCH DR, LAND O LAKES, FL 34639-4787
(813) 929-0733
(813) 903-4812
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA0011803L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA0011803L
LICENSE
PA
Enumeration date
02/09/2006
Last updated
02/24/2016
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