Healthcare Provider Details

I. General information

NPI: 1306314216
Provider Name (Legal Business Name): KENZI MEDSPA AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 6TH AVE S
NAPLES FL
34102-6745
US

IV. Provider business mailing address

900 6TH AVE S
NAPLES FL
34102-6745
US

V. Phone/Fax

Practice location:
  • Phone: 239-529-2864
  • Fax: 800-877-6470
Mailing address:
  • Phone: 239-529-2864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALDENE MCKENZIE
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 239-529-2864