Lawrence Owen Kollenberg, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS35765 Issued in FL

Practice address

316 Charlemagne Cir
Ponte Vedra Beach, FL 32082-2908

Phone

(904) 543-7681

NPI assigned

Jun 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992747448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 CHARLEMAGNE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822908",
            "telephone_number": "904-543-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CHARLEMAGNE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822908",
            "telephone_number": "904-543-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLENBERG",
        "first_name": "LAWRENCE",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS35765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dina Khentigan, DNP, RN, C-EFM, ACE-
• Amanda Khoury
• Andrew Brown King, PHD
• Leonie C King, NP
• Thomas Koby-Hercsky, DMD
• Kristin Koren
• Melissa Kotziers, PA-C
• Megan Leanne Krantz, PHD
• Macy Kwakenat
• Kyle Clinic

• Pharmacist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.