| Organization Name: | MECNB PCP, INC. |
| NPI Number: | 1962721100 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RENE CASANOVA (MEDICAL DIRECTOR) |
| Mailing Address: | 762 S Federal Hwy Deerfield Beach |
| State: | FL US |
| Postal Code: | 334415767 |
| Phone Number: | 9543790300 |
| Fax Number: | 9543790301 |
| NPI Enumeration Date: | 05/27/2010 |
| NPI Last Update Date: | 07/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME78770 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |