Organization Name: | FWC REI LLC |
NPI Number: | 1003102260 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH KONSKER (PRESIDENT) |
Mailing Address: | 4205 W Atlantic Ave #c-304 Delray Beach |
State: | FL US |
Postal Code: | 334453901 |
Phone Number: | 5613002410 |
Fax Number: | 5614955408 |
NPI Enumeration Date: | 06/24/2011 |
NPI Last Update Date: | 06/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VE0102X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Reproductive Endocrinology |
Taxonomy Definition: | An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |