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NPI Code Detail

MEDICARE: DR. NATHALIE KOENIG D.O.

MEDICARE: DR. NATHALIE KOENIG D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS 6856FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063421675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHALIE KOENIG D.O.
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number : 305-500-2000
Fax Number :
Provider Business Practice Location Address
First Line : 5480 GRIFFIN RD
Second Line :
City : DAVIE
State : FL
Zip : 33314-4539
Country : US
Telephone Number : 954-210-9770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 03/04/2026

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