MEDICARE: MCR HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	133VN1006X	Metabolic Nutrition Registered Dietitian
3	163WD0400X	Diabetes Educator Registered Nurse
4	207V00000X	Obstetrics & Gynecology Physician
5	208000000X	Pediatrics Physician
6	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245511625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCR HEALTH, INC.

Provider Business Mailing Address
First Line	:	101 RIVERFRONT BLVD STE 710
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-8812
Country	:	US
Telephone Number	:	941-776-4000
Fax Number	:	941-845-4963

Provider Business Practice Location Address
First Line	:	2318 MANATEE AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-5403
Country	:	US
Telephone Number	:	941-714-7150
Fax Number	:	941-714-3242

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MELVIN B PRICE
Credential	:
Telephone Number	:	941-776-4000

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	01/14/2025

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