Elizabeth Teresa Kondracka, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME41037 Issued in FL

Practice address

226 Coastal Hill Drive
Indian Harbour Beach, FL 32937-2751

Phone

(321) 777-5152

Fax

(321) 777-5152

NPI assigned

Feb 25, 2008

Last updated

Feb 25, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1033388939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 COASTAL HILL DRIVE",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329372751",
            "telephone_number": "321-777-5152",
            "fax_number": "321-777-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 COASTAL HILL DRIVE",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329372751",
            "telephone_number": "321-777-5152",
            "fax_number": "321-777-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRACKA",
        "first_name": "ELIZABETH",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME41037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0699039",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Joseph Kara, DMD
• Regina Marie Kaufmann, M.D.
• Kristen Noel Kennerley, A.P.
• Heather Killick, MPT
• Katherine Michelle Kimbrell, OT/L
• Monica Kostro, DDS
• Jayna Lacko
• Edward V Laibl, OD
• Timothy Corrigan Lang, DDS, MD, PHD
• Laylah Lara, PTA

• Family Medicine Physician in Indian Harbour Beach, FL
• Providers in Indian Harbour Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.