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NPI Code Detail

MEDICARE: MCR HEALTH, INC.

MEDICARE: MCR HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184277162
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCR HEALTH, INC.
Provider Business Mailing Address
First Line : 101 RIVERFRONT BLVD STE 710
Second Line :
City : BRADENTON
State : FL
Zip : 34205-8812
Country : US
Telephone Number : 941-776-4000
Fax Number :
Provider Business Practice Location Address
First Line : 14730 COBRA WAY
Second Line :
City : HUDSON
State : FL
Zip : 34669-1083
Country : US
Telephone Number : 941-776-4000
Fax Number :
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MELVIN B PRICE
Credential :
Telephone Number : 941-776-4000
Provider Enumeration Date : 07/19/2019
Last Update Date : 11/27/2023

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