Basic Information
| Provider Information | |||||||||
| NPI: | 1972641652 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCLEEREY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ANDREW | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 943 S BENEVA RD STE 306 | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342322499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419551108 | ||||||||
| FaxNumber: | 9419544440 | ||||||||
| Practice Location | |||||||||
| Address1: | 2881 HYDE PARK ST | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342393228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9413662460 | ||||||||
| FaxNumber: | 9413663015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 10/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 41138 | KY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME146685 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.