Healthcare Provider Details
I. General information
NPI: 1538006010
Provider Name (Legal Business Name): ATHENARECON LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
903 SE MONTEREY COMMONS BLVD
STUART FL
34996-3339
US
IV. Provider business mailing address
903 SE MONTEREY COMMONS BLVD # 903
STUART FL
34996-3339
US
V. Phone/Fax
- Phone: 772-324-8197
- Fax: 772-324-8143
- Phone: 772-324-8197
- Fax: 772-324-8143
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AVRON
LIPSCHITZ
Title or Position: CEO
Credential: MD
Phone: 772-324-8197