Individual
DR. CASEY SHEA MCGILLICUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803
(561) 252-3654
Mailing address
825 MCCULLOUGH AVE, ORLANDO, FL 32803-7202
(561) 252-3654
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME153673
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
04/10/2020
Last updated
08/08/2022
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