Healthcare Provider Details

I. General information

NPI: 1568439768
Provider Name (Legal Business Name): JOHN WARREN MCBROOM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11190 HEALTH PARK BLVD
NAPLES FL
34110-5729
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8080
  • Fax: 239-629-1000
Mailing address:
  • Phone: 717-851-6120
  • Fax: 717-409-6223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberD90981
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD460521
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME173734
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: