Provider Demographics
NPI:1104800283
Name:MCADORY, JOHN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:MCADORY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8401 SW 114TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4330
Mailing Address - Country:US
Mailing Address - Phone:305-235-5367
Mailing Address - Fax:305-253-8889
Practice Address - Street 1:11211 SW 152ND ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1101
Practice Address - Country:US
Practice Address - Phone:305-255-1355
Practice Address - Fax:305-255-2015
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 23179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD27639Medicare UPIN
FL92542Medicare ID - Type Unspecified