Provider Demographics
NPI:1912966292
Name:MCKAY-MALCOLM, DEBBIE MARIA (CRNA)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:MARIA
Last Name:MCKAY-MALCOLM
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9765 NW 63RD PL
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-1809
Mailing Address - Country:US
Mailing Address - Phone:786-208-9415
Mailing Address - Fax:954-851-1758
Practice Address - Street 1:9370 SUNSET DRIVE
Practice Address - Street 2:#A-250
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-595-4510
Practice Address - Fax:305-595-9465
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1703932367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301939000Medicaid