Mary Lee

Individual provider Active NPI Registered Nurse · Kenneth City, FL

NPI 1336074111 · NPPES record last updated Jun 15, 2026

Key facts

NPI
1336074111
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
9349997 (FL)
Practice address
6222 43Rd Ave N
Kenneth City, FL 33709-5020
Phone
(727) 272-0534
Fax
(727) 272-0534
NPI assigned
Jun 15, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9349997 FL Yes

Addresses

Primary practice location

6222 43Rd Ave N
Kenneth City, FL 33709-5020

Mailing address

6222 43Rd Ave N
Kenneth City, FL 33709-5020
Phone (727) 272-0534

Other providers in Kenneth City, FL

All providers in Kenneth City, FL · Registered Nurse in Florida

Sources for this page

Verify at the official NPI Registry.