MEDICARE: DR. JOHN WARREN MCBROOM MD

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	207VX0201X	Gynecologic Oncology Physician	D90981	MD
2	207VX0201X	Gynecologic Oncology Physician	MD460521	PA
3	207VX0201X	Gynecologic Oncology Physician	ME173734	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1568439768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WARREN MCBROOM MD

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-6120
Fax Number	:	717-409-6223

Provider Business Practice Location Address
First Line	:	11190 HEALTH PARK BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-5729
Country	:	US
Telephone Number	:	239-624-8080
Fax Number	:	239-629-1000

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	07/10/2025

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