Healthcare Provider Details
I. General information
NPI: 1245511625
Provider Name (Legal Business Name): MCR HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2011
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2318 MANATEE AVE W
BRADENTON FL
34205-5403
US
IV. Provider business mailing address
101 RIVERFRONT BLVD STE 710
BRADENTON FL
34205-8812
US
V. Phone/Fax
- Phone: 941-714-7150
- Fax: 941-714-3242
- Phone: 941-776-4000
- Fax: 941-845-4963
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1006X |
| Taxonomy | Metabolic Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELVIN
B
PRICE
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 941-776-4000