Mark Konwiser MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME00050766 Issued in FL

Legal business name

MARK KONWISER MD PA

Doing business as

Mark Konwiser MD PA

Practice address

900 Pine St
BLDG 1 Ste 122
Englewood, FL 34223-4418

Phone

(941) 474-8811

Fax

(941) 473-0058

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Konwiser, M.D.NPI 1316930092

Title

Owner/Physician

Phone

(941) 474-8811

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mark Konwiser MD PA Doing business as

Locations

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.

• Mark Konwiser, M.D.

  • Specialist
  • Englewood, FL
  • NPI 1316930092
  Authorized official Same address or phone

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1750497350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "address_2": "BLDG 1 STE 122",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234418",
            "telephone_number": "941-474-8811",
            "fax_number": "941-473-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PINE ST",
            "address_2": "BLDG 1 STE 122",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234418",
            "telephone_number": "941-474-8811",
            "fax_number": "941-473-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK KONWISER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "KONWISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "941-474-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME00050766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL LICENSE",
            "identifier": "85944",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC NUMBER FLORIDA",
            "identifier": "ME00050766",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE #",
            "identifier": "22-0003555",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "10D0295356",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark Konwiser MD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynn R Bernstein & Associates PA
• Mac Innovation
• Tayler Brianne Madison
• Margaret a. Gainey M.D.
• Kimberly Marino-Micheel, DOM,LAC,AP,DIPL,RN
• Jacquelyn Nikol Martinez
• Scott T Martz, DO
• Alvin Mathew, PT
• Holly Michelle Maxfield, APRN
• Whitney L May, M.S., BCBA

• Dermatology Physician in Englewood, FL
• Providers in Englewood, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.