Provider Demographics
NPI:1376570879
Name:MCKEE, ELIANA V (MD)
Entity Type:Individual
Prefix:MS
First Name:ELIANA
Middle Name:V
Last Name:MCKEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3747
Mailing Address - Country:US
Mailing Address - Phone:321-725-1999
Mailing Address - Fax:321-724-2422
Practice Address - Street 1:2501 W NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-3747
Practice Address - Country:US
Practice Address - Phone:321-725-1999
Practice Address - Fax:321-724-2422
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44235208000000X, 2080N0001X
FLME115201208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96829231Medicaid
FL008435800Medicaid
CO805779Medicare PIN
FL008435800Medicaid