Provider Demographics
NPI:1841267424
Name:PRICE, MELVIN BERNARD (DPM)
Entity type:Individual
Prefix:
First Name:MELVIN
Middle Name:BERNARD
Last Name:PRICE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 8TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:971-776-4000
Mailing Address - Fax:
Practice Address - Street 1:300 RIVERSIDE DR E STE 1500
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208
Practice Address - Country:US
Practice Address - Phone:941-741-3338
Practice Address - Fax:941-714-7484
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2875213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL191977OtherAMERIGROUP
FL340289400Medicaid
FLP102198OtherFREEDOM HEALTH
FL229615OtherAMERIGROUP DME
FL1995017777OtherTRICARE
FL22114178OtherUHC
FL34381OtherWELLCARE DME
FL480034307OtherRAILROAD
FL207952OtherWELLCARE
FL65677OtherBCBS
FL00459OtherUNIVERSAL MEDICARE MASTERPIECE
FL22114178OtherUHC
T63035Medicare UPIN