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General NPI Number Information
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NPI Number | 1285482984
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Entity Type | Individual
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Provider Name | MCKENZIE SAMSON RD, LD/N
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Gender | Female
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Dates
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Enumeration Date | 05/08/2024
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Last Update Date | 06/06/2026
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Provider Practice Location Address
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Address Line | 605 15TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32962-1436
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Country | US
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Telephone | 772-766-9656
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Fax |
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Provider Business Mailing Address
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Address Line | 605 15TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32962-1436
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Country | US
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Telephone | 772-766-9656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 7669
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License Number State | FL
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