Provider Demographics
NPI:1740258045
Name:MCGOOKEY, PATRICK MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:MCGOOKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 DEL PRADO BLVD N
Mailing Address - Street 2:UNIT 106
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2713
Mailing Address - Country:US
Mailing Address - Phone:239-772-5066
Mailing Address - Fax:239-772-4194
Practice Address - Street 1:126 DEL PRADO BLVD N
Practice Address - Street 2:UNIT 106
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2713
Practice Address - Country:US
Practice Address - Phone:239-772-5066
Practice Address - Fax:239-772-4194
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060048174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373171500Medicaid
FLA82404Medicare UPIN
FL373171500Medicaid