Provider Demographics
NPI:1962446633
Name:MCKENZIE, JUDITH CHRISTINA (DC)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:CHRISTINA
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 W. COLONIAL DRIVE STE. D
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:33818
Mailing Address - Country:US
Mailing Address - Phone:407-296-4848
Mailing Address - Fax:
Practice Address - Street 1:6500 W. COLONIAL DRIVE STE.D
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818
Practice Address - Country:US
Practice Address - Phone:407-296-4848
Practice Address - Fax:407-296-4846
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69874AMedicare ID - Type Unspecified
FLT85547Medicare UPIN