Healthcare Provider Details
I. General information
NPI: 1740574318
Provider Name (Legal Business Name): MCR HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2011
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6040 STATE ROAD 70 E
BRADENTON FL
34203-9720
US
IV. Provider business mailing address
101 RIVERFRONT BLVD STE 710
BRADENTON FL
34205-8812
US
V. Phone/Fax
- Phone: 941-316-8200
- Fax: 941-708-8893
- 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 | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELVIN
B
PRICE
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 941-776-4000