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General NPI Number Information
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NPI Number | 1851822522
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Entity Type | Organization
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Legal Business Name | MCBP ORTHOPEDICS AND NEUROSURGERY PLLC
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 4343 N US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34946-6434
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Country | US
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Telephone | 772-467-2677
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Fax | 772-467-2621
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Provider Business Mailing Address
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Address Line | 4343 N US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34946-6434
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Country | US
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Telephone | 772-467-2677
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Fax | 772-467-2621
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. MARC DAVID BRODSKY
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Credential | MC
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Telephone | 772-467-2677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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