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Mark Konwiser, MD
Specialist in Englewood, Florida
NPI 1316930092

Mark Konwiser is a Specialist based in Englewood, FL. Mark Konwiser practices in Englewood, FL and has the professional credentials of MD. The NPI Number for Mark Konwiser is 1316930092 and holds a License No. ME00050766 (Florida).

The current practice location address for Mark Konwiser is 900 Pine St, Englewood, FL and can be reached out via phone at 941-474-8811 and via fax at 941-473-0058.

Location: 900 Pine St, Englewood, FL, 34223-4418
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316930092
Provider Name
Mark Konwiser
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
900 Pine St, Englewood, FL, 34223-4418
Phone Number
941-474-8811
Fax Number
941-473-0058
Provider Enumeration Date
08/26/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
22-0003555 01 FL RAIL ROAD MEDICARE
85944 01 FL OCCUPATIONAL LICENSE
65-0596347 01 FL FEDERAL TAX #
10D0295356 01 FL CLIA #
ME00050766 01 FL FL LIC NUMBER
institution
Provider Business Practice Location Address Details
Address
900 Pine St
City
Englewood
State
Florida
Zip
34223-4418
Phone Number
941-474-8811
Fax Number
941-473-0058
person
Provider Business Mailing Address Details
Address
900 Pine St
City
Englewood
State
Florida
Zip
34223-4418
Phone Number
941-474-8811
Fax Number
941-473-0058
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ME00050766 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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