| Wilfred C Mckenzie Pa | |
|
1625 Se 3rd Ave Suite 400 Fort Lauderdale FL 33316-2521 | |
| (954) 832-0055 | |
| (954) 832-0063 |
| Full Name | Wilfred C Mckenzie Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1625 Se 3rd Ave, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Wilfred Clifton Mckenzie (PRESIDENT) |
| Authorized Official Contact | 9548320055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilfred C Mckenzie Pa 1625 Se 3rd Ave Suite 400 Fort Lauderdale FL 33316-2521 Ph: (954) 832-0055 | Wilfred C Mckenzie Pa 1625 Se 3rd Ave Suite 400 Fort Lauderdale FL 33316-2521 Ph: (954) 832-0055 |
| NPI Number | 1295705838 |
|---|---|
| Provider Enumeration Date | 01/25/2006 |
| Last Update Date | 09/13/2010 |
| Medicare PECOS PAC ID | 2668463266 |
|---|---|
| Medicare Enrollment ID | O20040521000811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295705838 | NPI | - | NPPES |
| 257017300 | Medicaid | FL | |
| 371522100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0059669 (Florida) | Primary |
| Provider Name | Rona M Mckenzie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851450530 PECOS PAC ID: 5496801441 Enrollment ID: I20090916000794 |
| Provider Name | Wilfred C Mckenzie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245399963 PECOS PAC ID: 0648261248 Enrollment ID: I20090916000818 |
| Provider Name | Michelle Binns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962561647 PECOS PAC ID: 4789730698 Enrollment ID: I20090917000673 |
| Provider Name | Sherine J Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235542507 PECOS PAC ID: 8628398823 Enrollment ID: I20150528001781 |
| Provider Name | Montia Melissa Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245636067 PECOS PAC ID: 4880016799 Enrollment ID: I20200623002255 |
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