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NPI Code Detail

MEDICARE: KATHRYN ALYSSA DZIWULSKI

MEDICARE: KATHRYN ALYSSA DZIWULSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistAY3012FL

General Provider Information

NPI Number : 1124954854
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN ALYSSA DZIWULSKI
Provider Business Mailing Address
First Line : 11945 SAN JOSE BLVD STE 300
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-1627
Country : US
Telephone Number : 904-396-1725
Fax Number :
Provider Business Practice Location Address
First Line : 3627 UNIVERSITY BLVD S STE 500
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-7405
Country : US
Telephone Number : 904-858-1912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/23/2026

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Directions to “ KATHRYN ALYSSA DZIWULSKI ” Practice Location

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