MEDICARE: ROBERT MCKAY III

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1144976853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MCKAY III

Provider Business Mailing Address
First Line	:	13921 JACKSON ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-6220
Country	:	US
Telephone Number	:	786-227-9269
Fax Number	:

Provider Business Practice Location Address
First Line	:	13921 JACKSON ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-6220
Country	:	US
Telephone Number	:	786-227-9269
Fax Number	:

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

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

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