Space Coast Foot & Ankle Center
LBN: John D Mackenney Pa
Space Coast Foot & Ankle Center is an health care organization with primary practice located at 6550 N Wickham Rd Ste 4 , Melbourne FL 32940-2038. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is the primary health care specialty.
John D Mackenney Pa can be contacted via phone (321) 259-4268, or through Mackenney, John David via phone (321) 259-4268.
Contact Information
Primary practice address
6550 N Wickham Rd Ste 4
Melbourne FL 32940-2038
Phone: (321) 259-4268
Fax:
Website:
Authorized official contact:
Name: Mackenney, John David Doctor of Podiatric Medicine (DPM)
Phone: (321) 259-4268
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | PO3043 | Florida |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1841472479 |
|---|---|
| LBN Legal business name | John D Mackenney Pa |
| DBA Doing business as | Space Coast Foot & Ankle Center |
| Authorized official | Mackenney, John David Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 5th, 2007 |
| Last updated | Aug 9th, 2011 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841472479 | NPPES |
| Florida | MEDICAID | 340376900 |
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