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General NPI Number Information
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NPI Number | 1023238284
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Entity Type | Organization
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Legal Business Name | MCBATH MEDICAL CENTER PA
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 13933 17TH ST STE: 101
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City | DADE CITY
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State | FL
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Zip | 33525-4603
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Country | US
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Telephone | 352-567-6763
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Fax | 352-567-1358
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Provider Business Mailing Address
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Address Line | 13933 17TH ST STE: 101
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City | DADE CITY
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State | FL
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Zip | 33525-4603
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Country | US
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Telephone | 352-567-6763
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Fax | 352-567-1358
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. DANIEL PHILIP MCBATH
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Credential | D.O.
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Telephone | 352-567-6763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | FC1011371
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS6111
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License Number State | FL
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