Provider Demographics
NPI:1730583048
Name:MCKEE, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15240 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1809
Mailing Address - Country:US
Mailing Address - Phone:813-962-6133
Mailing Address - Fax:813-280-7040
Practice Address - Street 1:15240 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1809
Practice Address - Country:US
Practice Address - Phone:813-962-6133
Practice Address - Fax:813-280-7040
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42058183500000X
IN26018373A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist