Individual
MARK MCKENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11760 BIRD RD, SUITE 722, MIAMI, FL 33175-3582
(305) 559-1883
(305) 559-1887
Mailing address
11760 BIRD RD, SUITE 722, MIAMI, FL 33175-3582
(305) 559-1883
(305) 559-1887
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME57722
FL
2086S0102X
Surgical Critical Care Physician
ME57722
FL
2086S0127X
Trauma Surgery Physician
Primary
ME57722
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3707504-00
—
FL
Enumeration date
12/18/2006
Last updated
02/09/2022
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