MEDICARE: MS. ELIANA V MCKEE M.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	208000000X	Pediatrics Physician	44235	CO
2	2080N0001X	Neonatal-Perinatal Medicine Physician	44235	CO
3	208000000X	Pediatrics Physician	ME115201	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

General Provider Information

NPI Number	:	1376570879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIANA V MCKEE M.D.

Provider Business Mailing Address
First Line	:	2501 W NEW HAVEN AVE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32904-3747
Country	:	US
Telephone Number	:	321-725-1999
Fax Number	:	321-724-2422

Provider Business Practice Location Address
First Line	:	2501 W NEW HAVEN AVE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32904-3747
Country	:	US
Telephone Number	:	321-725-1999
Fax Number	:	321-724-2422

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	03/17/2018

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