MEDICARE: JANUARIUSZ L. STYPEREK MD PA

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	174400000X	Specialist	ME 0027142	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	93360	OTHER	FL	BCBS OF FL
3	110013019	OTHER	FL	PALMETTO GBA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932313186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANUARIUSZ L. STYPEREK MD PA

Provider Business Mailing Address
First Line	:	2314 S SEACREST BLVD
Second Line	:	SUITE 102
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6788
Country	:	US
Telephone Number	:	561-732-1586
Fax Number	:	561-732-3160

Provider Business Practice Location Address
First Line	:	2314 S SEACREST BLVD
Second Line	:	SUITE 102
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6788
Country	:	US
Telephone Number	:	561-732-1586
Fax Number	:	561-732-3160

Authorized Official
Title or Position	:	MEDICAL BILLING SPECIALIST
Name	:	MS. SONIA CUEVAS
Credential	:
Telephone Number	:	561-732-1586

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	01/14/2010

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