Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME150929 | FL |
N | 111NI0900X | Internist | ME150929 | FL |
N | 207RC0000X | Internist - Cardiovascular Disease | C134853 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | ME150929 | FL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | C134853 | CA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME150929 | FL |
NPI | 1023208493 |
---|---|
Provider Name | Thomas Konecny |
First Address | Gainesville, FL 32610-0277 |
Second Address | Gainesville, FL 32608-1135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2007 |
Last Update Date | 02/09/2021 |