MARK KONICKI MD - NPI 1649250523 - Internal Medicine in Jacksonville, FL

Q: What is Mark Konicki's NPI number?

The NPI number for Mark Konicki is 1649250523. It was assigned to this individual provider in the NPPES registry on January 18, 2006.

Q: What is Mark Konicki's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Konicki was last updated on May 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

On this page

About Mark Konicki Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK KONICKI MD (NPI 1649250523) is an individual internal medicine provider in Jacksonville, Florida, licensed in Florida (ME60881) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1649250523

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMARK KONICKICredential: MD

Location Address820 PRUDENTIAL DR STE 304Jacksonville, FL 32207-8205

Mailing AddressPo Box 44004Jacksonville, FL 32231-4004 · (904) 202-1032 · Fax (904) 357-5627

Phone(904) 364-3649

Fax(904) 357-5627

Sole ProprietorNo

Enumeration DateJanuary 18, 2006

Last NPPES UpdateMay 17, 20162 updates tracked since enumeration

✔ NPI 1649250523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in FL · ME60881

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 01071892A (IN)

820 PRUDENTIAL DR STE 304, Jacksonville, FL 32207

Open in Google Maps ↗

Other Identifiers 3

Medicare PIN23337MFL

Medicaid373993799FL

OtherRAILROAD MEDICAREFL · P01551193

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRELA MUSSALLAM ABU SHAIBEH

Hospitalist