Individual
MR. MICHAEL B. MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
19611 SR 20 W, BLOUNTSTOWN, FL 32424-3917
(850) 674-5645
(850) 674-5420
Mailing address
19611 SR 20 W, BLOUNTSTOWN, FL 32424-3917
(850) 674-5645
(850) 674-5420
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1486662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027949891
—
FL
Enumeration date
07/07/2006
Last updated
01/15/2013
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