Provider Demographics
NPI:1124515762
Name:KONIG, CHRISTOPHER EPHREM (PHARMD, MBA, RAC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EPHREM
Last Name:KONIG
Suffix:
Gender:M
Credentials:PHARMD, MBA, RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4584 GRAND PRESERVE PL
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4584 GRAND PRESERVE PL
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1052
Practice Address - Country:US
Practice Address - Phone:813-406-2105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty