MK Surgical Service Inc

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

MK SURGICAL SERVICE INC

Practice address

2121 N Ocean Blvd Apt 306W
Boca Raton, FL 33431-7876

Phone

(630) 242-0420

NPI assigned

Dec 28, 2020

Last updated

Jan 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maria F Konieczko, CSANPI 1891095196

Title

Owner

Phone

(630) 242-0420

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria Fernanda Konieczko

  • Surgical Physician Assistant
  • Boca Raton, FL
  • NPI 1891095196
  NPD Authorized official

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1679160535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N OCEAN BLVD APT 306W",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317876",
            "telephone_number": "630-242-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N OCEAN BLVD APT 306W",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317876",
            "telephone_number": "630-242-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK SURGICAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2021-01-07",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "KONIECZKO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-242-0420",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.