MEDICARE: MCLINICIAN

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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1770959611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCLINICIAN

Provider Business Mailing Address
First Line	:	118 CARRS TRL
Second Line	:
City	:	GREENE
State	:	RI
Zip	:	02827-1808
Country	:	US
Telephone Number	:	855-883-6286
Fax Number	:	855-883-6286

Provider Business Practice Location Address
First Line	:	5051 NW 13TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-8650
Country	:	US
Telephone Number	:	855-883-6286
Fax Number	:	855-883-6286

Authorized Official
Title or Position	:	CEO & PRESIDENT
Name	:	DR. DAVID C HUGHES
Credential	:	PHARMD
Telephone Number	:	401-481-3001

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	08/14/2015

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Directions to “MCLINICIAN ” Practice Location

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