Provider Demographics
NPI:1780357749
Name:MCKENZIE, ANNALEISE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANNALEISE
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 HERITAGE TRL STE 301
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-8716
Mailing Address - Country:US
Mailing Address - Phone:239-649-6848
Mailing Address - Fax:
Practice Address - Street 1:1725 HERITAGE TRL STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-8716
Practice Address - Country:US
Practice Address - Phone:239-649-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30033225100000X
225100000X
FLPT375552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist