Provider Demographics
NPI:1972625218
Name:MCCARTHY, HEATHER CARRICOFFE (DO)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:CARRICOFFE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANN
Other - Last Name:CARRICOFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:770 CLAUGHTON ISLAND DR
Mailing Address - Street 2:APT 2115
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2617
Mailing Address - Country:US
Mailing Address - Phone:305-903-6165
Mailing Address - Fax:
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:NSU UNIVERSITY CENTER SPORTS MEDICINE DEPT
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33314
Practice Address - Country:US
Practice Address - Phone:954-262-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine