MEDICARE: MICHAEL R MCCLURE DC

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
1	111N00000X	Chiropractor	CH13190	FL
2	111N00000X	Chiropractor	DC009218	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001606018	OTHER	PA	HIGHMARK BLUE CROSS SHIEL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437295573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL R MCCLURE DC

Provider Business Mailing Address
First Line	:	5420 LAND O LAKES BLVD STE 105
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-3401
Country	:	US
Telephone Number	:	813-996-9800
Fax Number	:	813-996-3323

Provider Business Practice Location Address
First Line	:	5420 LAND O LAKES BLVD STE 105
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-3401
Country	:	US
Telephone Number	:	813-996-9800
Fax Number	:	813-996-3326

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	10/10/2024

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