MEDICARE: MARCUS ALLEN MCKEE BCBA

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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215266465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS ALLEN MCKEE BCBA

Provider Business Mailing Address
First Line	:	5076 CREEKSIDE TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-3898
Country	:	US
Telephone Number	:	850-445-4905
Fax Number	:

Provider Business Practice Location Address
First Line	:	5076 CREEKSIDE TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-3898
Country	:	US
Telephone Number	:	623-590-0037
Fax Number	:	844-308-5830

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2009
Last Update Date	:	03/02/2021

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