Healthcare Provider Details

I. General information

NPI: 1720568330
Provider Name (Legal Business Name): ARTUR ZMIEJKO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 59TH ST W
BRADENTON FL
34209-4602
US

IV. Provider business mailing address

3675 PARKRIDGE CIR
SARASOTA FL
34243-1446
US

V. Phone/Fax

Practice location:
  • Phone: 941-761-1000
  • Fax:
Mailing address:
  • Phone: 941-301-5751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA28618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: