| Doctor Name: | MR. MICHAEL B. MCKENZIE |
| NPI Number: | 1265464226 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | 1486662 |
| Business Practice Address: | 19611 Sr 20 W Blountstown, FL - 324243917 |
| Business Phone Number: | 8506745645 |
| Business Fax Number: | 8506745420 |
| Mailing Address: | 19611 Sr 20 W, BLOUNTSTOWN |
| State: | FL |
| Postal Code: | 324243917 |
| Phone Number: | 8506745645 |
| Fax Number: | 8506745420 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 01/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 1486662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |