Provider Demographics
NPI:1538895008
Name:MCBRIDE, SHONTEL MERIA (HOME HEALTH CARE)
Entity type:Individual
Prefix:
First Name:SHONTEL
Middle Name:MERIA
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:HOME HEALTH CARE
Other - Prefix:
Other - First Name:SHONTEL
Other - Middle Name:MERIA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1450 S MLK JR AVE APT 708
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3483
Mailing Address - Country:US
Mailing Address - Phone:727-269-0629
Mailing Address - Fax:
Practice Address - Street 1:1450 S MLK JR AVE APT 708
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3483
Practice Address - Country:US
Practice Address - Phone:727-560-7481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide