Healthcare Provider Details

I. General information

NPI: 1851168744
Provider Name (Legal Business Name): MCCREA PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1787 BEARBERRY CIR APT 102
LUTZ FL
33559-8763
US

IV. Provider business mailing address

PO BOX 1567
LAND O LAKES FL
34639-1567
US

V. Phone/Fax

Practice location:
  • Phone: 813-758-0483
  • Fax:
Mailing address:
  • Phone: 813-758-0483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SYLVIA L MCCREA
Title or Position: PRESIDENT
Credential:
Phone: 813-413-1145