Provider Demographics
NPI:1518112523
Name:MCKEE FAMILY PRACTICE PA
Entity Type:Organization
Organization Name:MCKEE FAMILY PRACTICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DIONNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-752-7555
Mailing Address - Street 1:7000 SPY GLASS CT.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8288
Mailing Address - Country:US
Mailing Address - Phone:321-752-7555
Mailing Address - Fax:321-757-9988
Practice Address - Street 1:7000 SPY GLASS CT.
Practice Address - Street 2:SUITE 300
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-8288
Practice Address - Country:US
Practice Address - Phone:321-752-7555
Practice Address - Fax:321-757-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty