Basic Information
| Provider Information | |||||||||
| NPI: | 1760422257 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MBR & ASSOCIATES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4519 GEORGE RD | ||||||||
| Address2: | STE 125 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336347329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134961075 | ||||||||
| FaxNumber: | 8132497762 | ||||||||
| Practice Location | |||||||||
| Address1: | 4519 GEORGE RD | ||||||||
| Address2: | STE 125 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336347329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134961075 | ||||||||
| FaxNumber: | 8132497762 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 07/15/2014 | ||||||||
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| AuthorizedOfficialLastName: | MARTINEZ | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN. ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 8134961075 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171W00000X | 18592.0000 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Contractor |
No ID Information.