Healthcare Provider Details
I. General information
NPI: 1134599723
Provider Name (Legal Business Name): MCR HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2015
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
888 N ROBERT AVE
ARCADIA FL
34266-9580
US
IV. Provider business mailing address
101 RIVERFRONT BLVD STE 710
BRADENTON FL
34205-8812
US
V. Phone/Fax
- Phone: 863-494-8401
- Fax: 863-993-7622
- Phone: 941-776-4000
- Fax: 941-845-4963
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELVIN
B
PRICE
SR.
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 941-776-4000