CANDACE MCKINZIE


Address: 2416 Granby St, Sanford, FL 32771-9654
Phone: 3212622879

CANDACE MCKINZIE (NPI# 1760998058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760998058
Entity Type Individual
Full Name CANDACE MCKINZIE
Practice Address 2416 Granby St
Sanford
FL 32771-9654
Mailing Address 2416 Granby Ave
Sanford
FL 32771
Practice Telephone 3212622879
Practice Fax Number 3212622879
Mailing Telephone 3212622879
Enumeration Date 2017-12-21
Last Update Date 2018-06-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TM1800X Psychologist
Specialization: Mental Retardation & Developmental Disabilities
Behavioral Health & Social Service Providers

Office Location

Street Address 2416 GRANBY ST
City SANFORD
State FL
Zip Code 32771-9654

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NPI Name Taxonomy Address Enumeration
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1881132249 Tracy Shibla Nurse Practitioner 2320 Retreat View Cir, Sanford, FL 32771 2017-02-06
1205387206 Tabitha Boyd Behavior Technician 4136 Geranium Ln #102, Sanford, FL 32771 2016-10-14
1104275874 Jessica Willis Nurse Anesthetist, Certified Registered 108 Temple Dr, Sanford, FL 32771 2016-06-03
1013379957 Bai Medical LLC Point of Service 580 Lexington Green Lane, Sanford, FL 32771 2016-03-21
1710347851 Melissa T Ramsawak Nurse Practitioner 4930 East Lake Mary Boulevard, Sanford, FL 32771 2016-03-02
1811394570 Tanesha Burns Counselor 209 San Carlos Ave Ste 111a, Sanford, FL 32771 2014-11-24
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Taxonomy Information

Taxonomy Code 103TM1800X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Mental Retardation & Developmental Disabilities

Taxonomy Definition

Definition to come...

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1235748500 Ruth J Keili Psychologist 3562 Old Village Dr, Orange Park, FL 32065-5521 2020-07-23
1609410059 Barbara Ann Davis Psychologist 1324 Fairway Village Dr, Fleming Island, FL 32003-8398 2019-10-29
1417599531 Bernice L Walker Psychologist 2449 Bracknell Forest Trl, Tavares, FL 32778-5706 2019-10-09
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1114497278 Tayana Washington Psychologist 2008 Se 45th Terr, Gainesville, FL 32641-3264 2018-12-03
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1205331881 Tyric Lamont Drummond Psychologist 990 62nd Ter S, Saint Petersburg, FL 33705-5819 2018-03-27
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Competitor

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City SANFORD
Zip Code 32771

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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