MEDICARE: EWA D. PISZCZEK M.D.

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
1	207R00000X	Internal Medicine Physician	MD12187	RI
2	207R00000X	Internal Medicine Physician	ME107864	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881708782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EWA D. PISZCZEK M.D.

Provider Business Mailing Address
First Line	:	3901 COCONUT PALM DR STE 120
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-8362
Country	:	US
Telephone Number	:	813-289-6597
Fax Number	:	865-769-3454

Provider Business Practice Location Address
First Line	:	3901 COCONUT PALM DR STE 120
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-8362
Country	:	US
Telephone Number	:	813-289-6597
Fax Number	:	865-769-3454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	03/17/2018

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Directions to “ EWA D. PISZCZEK M.D.” Practice Location

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