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Export Provider Record NPI 1366420754
Kenneth Aron MackM.D.
Active
NPI Number1366420754
NPI TypeNPI-1 Individual
SpecialtyInternal Medicine
Provider Details
NPI1366420754
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-01-05
Last Updated2007-07-08
Mailing Address1551 Sawgrass Corporate Pkwy, Suite 110
Sunrise, FL 33323-2828
United States
Phone: (954) 835-0750 | Fax: (954) 835-7060
📍 View Map
Primary Practice Address1551 Sawgrass Corporate Pkwy, Suite 110
Sunrise, FL 33323-2828
United States
Phone: (954) 835-0750 | Fax: (954) 835-7060
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDFL250714500-
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207R00000X – Internal MedicineFLME69814
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About NPI 1366420754

Kenneth Aron Mack M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1366420754. The primary specialty listed is Internal Medicine. The provider is located in Sunrise, FL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-01-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1366420754?

NPI 1366420754 belongs to Kenneth Aron Mack M.D., a Internal Medicine in Sunrise, FL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1366420754 active?

The current status of NPI 1366420754 in the NPPES registry is Active. The record was last updated on 2007-07-08.

What specialty is NPI 1366420754?

NPI 1366420754 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1366420754?

You can verify NPI 1366420754 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1366420754?

The primary practice address on file for NPI 1366420754 is 1551 Sawgrass Corporate Pkwy, Sunrise, FL 33323-2828. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1366420754 issued?

NPI 1366420754 was first issued (enumerated) on 2006-01-05. The NPPES record was last updated on 2007-07-08.

Practice Location Map

Kenneth Aron Mack is located at 1551 Sawgrass Corporate Pkwy, Sunrise, FL. Use the map below to find directions or verify the practice location.

📍 1551 Sawgrass Corporate Pkwy, Sunrise, FL 33323-2828  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Kenneth Aron Mack. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1366420754. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Internal MedicineME69814FL
Data Verified from CMS NPPES Last synced: 2026-08-18 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162