MEDICARE: MELANIE MCBRIDE

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	225200000X	Physical Therapy Assistant	PTA30287	FL

General Provider Information

NPI Number	:	1992397962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MCBRIDE

Provider Business Mailing Address
First Line	:	12013 MAGAZINE ST APT 8309
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-5508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12013 MAGAZINE ST APT 8309
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-5508
Country	:	US
Telephone Number	:	813-509-7829
Fax Number	:

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

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	02/10/2021

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Directions to “ MELANIE MCBRIDE ” Practice Location

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