MEDICARE: 365MEDMCKENNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1134087562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	365MEDMCKENNA

Provider Business Mailing Address
First Line	:	2212 SE 3RD ST
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7210
Country	:	US
Telephone Number	:	341-758-2097
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 SE 3RD ST
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7210
Country	:	US
Telephone Number	:	341-758-2097
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TISHA MCKENNA
Credential	:
Telephone Number	:	341-758-2097

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

Similar Medicare Providers

1144934357 — KRISTI EVE CRAWFORD
Practice Location Address:

179 MACK BAYOU LOOP STE 201
SANTA ROSA BEACH, FL
32459-7210

Practice Phone: 850-233-6922
Practice Fax:

1790487239 — CHRISTINE REITZ OTR/L
Practice Location Address:

179 MACK BAYOU LOOP STE 302
SANTA ROSA BEACH, FL
32459-7210

Practice Phone: 850-278-3398
Practice Fax:

1730884560 — DR. DONGSU KIM DDS
Practice Location Address:

1799 N WILLIAMSON BLVD APT 7210
DAYTONA BEACH, FL
32117-5309

Practice Phone: 804-937-9680
Practice Fax:

1437020732 — FAMILY FIRST OUTPATIENT SERVICES
Practice Location Address:

6861 DONALD ROSS RD
PALM BEACH GARDENS, FL
33418-7210

Practice Phone: 561-328-7370
Practice Fax:

1841136595 — COURTNEY LOREA HARKLESS BSN, RN
Practice Location Address:

834 E 4TH ST UNIT 5
LONG BEACH, CA
90802-7210

Practice Phone: 323-304-5223
Practice Fax:

1124717525 — THU TANG APRN
Practice Location Address:

2314 S SEACREST BLVD STE 102
BOYNTON BEACH, FL
33435-6788

Practice Phone: 561-735-7766
Practice Fax:

Directions to “365MEDMCKENNA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.