MEDICARE: MR. STEVEN MCKENZY PH.D

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	174400000X	Specialist	MA 37847	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710024526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN MCKENZY PH.D

Provider Business Mailing Address
First Line	:	528 S SEMINOLE AVE
Second Line	:
City	:	FORT MEADE
State	:	FL
Zip	:	33841-3448
Country	:	US
Telephone Number	:	863-448-7476
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 N CHARLESTON AVE
Second Line	:
City	:	FORT MEADE
State	:	FL
Zip	:	33841-2403
Country	:	US
Telephone Number	:	863-448-7476
Fax Number	:

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	03/10/2026

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