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General NPI Number Information
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NPI Number | 1609173806
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Entity Type | Organization
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Legal Business Name | FLORIDA WOMAN CARE LLC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 501 NW LAKE WHITNEY PL SUITE 106
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City | PORT ST. LUCIE
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State | FL
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Zip | 34986-1615
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Country | US
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Telephone | 561-300-2410
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Fax | 561-495-5408
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Provider Business Mailing Address
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Address Line | 4205 W ATLANTIC AVE SUITE C304
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3901
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Country | US
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Telephone | 561-300-2410
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Fax | 561-495-5408
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH KONSKER
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Credential | MD
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Telephone | 561-300-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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