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NPI Code Detail

MEDICARE: DR. MARVIN R MCBRIDE JR. M.D.

MEDICARE: DR. MARVIN R MCBRIDE JR. M.D.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician01039483IN
2208M00000XHospitalist Physician62200-20WI
3208M00000XHospitalist Physician01039483IN
4208M00000XHospitalist PhysicianME119775FL

Other Identifiers

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

General Provider Information

NPI Number : 1730189499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARVIN R MCBRIDE JR. M.D.
Provider Business Mailing Address
First Line : 1600 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3065
Country : US
Telephone Number : 863-680-7000
Fax Number : 866-264-8519
Provider Business Practice Location Address
First Line : 1600 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3065
Country : US
Telephone Number : 863-680-7000
Fax Number : 866-264-8519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 04/10/2025

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