Provider Demographics
NPI:1427076447
Name:MCKENZIE, MARK KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:KEVIN
Last Name:MCKENZIE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:901 N LAKE DESTINY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4844
Mailing Address - Country:US
Mailing Address - Phone:407-200-2857
Mailing Address - Fax:407-200-1365
Practice Address - Street 1:901 N LAKE DESTINY RD
Practice Address - Street 2:STE 400
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4844
Practice Address - Country:US
Practice Address - Phone:407-200-2857
Practice Address - Fax:407-200-1365
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLME0074040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine