Individual
DR. KONSTANTIN ALEKSEYENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10080 SW INNOVATION WAY STE 201, PORT ST LUCIE, FL 34987-2129
(772) 344-3811
(772) 344-3890
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-2832
(772) 344-3890
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
OS14266
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728500
—
FL
01
—
M4TKZ
FLORIDA BLUE
FL
Enumeration date
05/23/2015
Last updated
10/14/2020
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