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General NPI Number Information
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NPI Number | 1366243891
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Entity Type | Organization
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Legal Business Name | KONGNYUY UROLOGY PLLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 2232 COLLEGE ST APT 3
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3123
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Country | US
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Telephone | 904-323-1484
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Fax | 216-208-1524
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Provider Business Mailing Address
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Address Line | 2232 COLLEGE ST APT 3
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL KONGNYUY
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Credential | MD
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Telephone | 608-738-8867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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