Provider Demographics
NPI:1831147578
Name:MCKENZIE, JANA L (MD)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:L
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR STE 6200
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3416
Mailing Address - Country:US
Mailing Address - Phone:562-820-8580
Mailing Address - Fax:561-820-8581
Practice Address - Street 1:1411 N FLAGLER DR STE 6200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3416
Practice Address - Country:US
Practice Address - Phone:561-820-8580
Practice Address - Fax:561-820-8581
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63601207R00000X
FLME135847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4504Medicare ID - Type Unspecified