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General NPI Number Information
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NPI Number | 1386829315
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Entity Type | Organization
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Legal Business Name | NATHALIE A KOENIG DO
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2301 N UNIVERSITY DR SUITE 211
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3617
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Country | US
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Telephone | 954-894-3012
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Fax | 954-894-0421
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Provider Business Mailing Address
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Address Line | 2301 N UNIVERSITY DR SUITE 211
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3617
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Country | US
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Telephone | 954-894-3012
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Fax | 954-894-0421
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Authorized Official
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Title or Position | PRESIDENT
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Name | NATHALIE A KOENIG
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Credential | DO
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Telephone | 954-894-3012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS6856
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License Number State | FL
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