Dr. Konstantin Alekseyenko
Family Doctor - Adult Medicine
10080 Sw Innovation Way Ste 201
Port St Lucie
, Florida 34987-2129
Dr. Konstantin Alekseyenko
Family Doctor - Adult Medicine
10080 Sw Innovation Way Ste 201
Port St Lucie
, Florida 34987-2129
(772) 344-3890
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Dr. Konstantin Alekseyenko
- Po Box 417
- Stuart, FL
- Zip : 34995-0417
- Fax : (772) 344-3890
- Phone : (772) 223-2832
Second Address
- Dr. Konstantin Alekseyenko
- 10080 Sw Innovation Way Ste 201
- Port St Lucie, FL
- Zip : 34987-2129
- Fax : (772) 344-3890
- Phone : (772) 344-3811
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | OS14266 | FL |
National Provider Identifier
| NPI | 1164801130 |
|---|---|
| Provider Name | Dr. Konstantin Alekseyenko |
| First Address | Stuart, FL 34995-0417 |
| Second Address | Port St Lucie, FL 34987-2129 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/05/2015 |
| Last Update Date | 14/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100728500 | (05) | FL |
| M4TKZ | FLORIDA BLUE (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.