Provider Demographics
NPI:1588656201
Name:MCBRIDE, PAUL V (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:V
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 TARPON WOODS BLVD
Mailing Address - Street 2:STE.F5
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2011
Mailing Address - Country:US
Mailing Address - Phone:727-785-2771
Mailing Address - Fax:727-785-2771
Practice Address - Street 1:800 TARPON WOODS BLVD
Practice Address - Street 2:STE.F5
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2011
Practice Address - Country:US
Practice Address - Phone:727-785-2771
Practice Address - Fax:727-785-2771
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88793Medicare ID - Type Unspecified