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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164801130 NPPES
Florida MEDICAID 100728500
Florida Other M4TKZ

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