Healthcare Provider Details
I. General information
NPI: 1912937590
Provider Name (Legal Business Name): MCR HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2703 19TH STREET CT E
BRADENTON FL
34208-7605
US
IV. Provider business mailing address
101 RIVERFRONT BLVD STE 710
BRADENTON FL
34205-8812
US
V. Phone/Fax
- Phone: 941-708-8500
- Fax: 941-708-8893
- Phone: 941-776-4000
- Fax: 941-845-4963
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PATRICK
CARNEGIE
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 941-776-4000