Provider Demographics
NPI:1851822522
Name:MCBP ORTHOPEDICS AND NEUROSURGERY PLLC
Entity Type:Organization
Organization Name:MCBP ORTHOPEDICS AND NEUROSURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:772-467-2677
Mailing Address - Street 1:4343 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34946-6434
Mailing Address - Country:US
Mailing Address - Phone:772-467-2677
Mailing Address - Fax:772-467-2621
Practice Address - Street 1:4343 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34946-6434
Practice Address - Country:US
Practice Address - Phone:772-467-2677
Practice Address - Fax:772-467-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty