Provider Demographics
NPI:1902366008
Name:ABERCROMBIE DEWEES, MCKENNA BRYN (DO)
Entity Type:Individual
Prefix:
First Name:MCKENNA
Middle Name:BRYN
Last Name:ABERCROMBIE DEWEES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MCKENNA
Other - Middle Name:
Other - Last Name:ABERCROMBIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:866-400-3376
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:540 MEDICAL OAKS AVE STE 102
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5995
Practice Address - Country:US
Practice Address - Phone:866-400-3376
Practice Address - Fax:813-651-1401
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20117207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology