Provider Demographics
NPI:1255727103
Name:MCKENNA, LUKE (MD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:MCKENNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12550 PROFESSIONAL PARK DR
Mailing Address - Street 2:UNIT 11
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-7957
Mailing Address - Country:US
Mailing Address - Phone:239-768-2111
Mailing Address - Fax:239-482-4404
Practice Address - Street 1:9911 CORKSCREW ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928
Practice Address - Country:US
Practice Address - Phone:239-768-2111
Practice Address - Fax:239-482-4404
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME134036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics