Alekseyenko, Konstantin
Alekseyenko, Konstantin is an individual health care provider with primary practice located at 10080 Sw Innovation Way Ste 201 , Port St Lucie FL 34987-2129. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Alekseyenko, Konstantin can be contacted via phone (772) 344-3811.Contact Information
Primary practice address
10080 Sw Innovation Way Ste 201
Port St Lucie FL 34987-2129
Phone: (772) 344-3811
Fax: (772) 344-3890
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | OS14266 | Florida |
Profile Details
NPI number | 1164801130 |
---|---|
LBN Legal business name | Alekseyenko, Konstantin |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 23rd, 2015 |
Last updated | Oct 14th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164801130 | NPPES |
Florida | MEDICAID | 100728500 | |
Florida | Other | M4TKZ |
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