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General NPI Number Information
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NPI Number | 1548654601
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Entity Type | Individual
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Provider Name | CHUNGYIKEM CONEY
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Gender | Male
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 5600 SW 12 ST APT A220
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City | N LAUDERDALE
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State | FL
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Zip | 33068
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Country | US
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Telephone | 754-281-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 5600 SW 12TH ST APT A220
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City | N LAUDERDALE
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State | FL
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Zip | 33068-4092
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Country | US
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Telephone | 754-281-4100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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