Provider Demographics
NPI:1225646763
Name:PFK513 LLC
Entity Type:Organization
Organization Name:PFK513 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOEN-KIEWERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-244-6488
Mailing Address - Street 1:4854 PINOT ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5162
Mailing Address - Country:US
Mailing Address - Phone:214-244-6488
Mailing Address - Fax:
Practice Address - Street 1:4854 PINOT ST
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5162
Practice Address - Country:US
Practice Address - Phone:214-244-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care