Healthcare Provider Details

I. General information

NPI: 1356392773
Provider Name (Legal Business Name): HENRY A. HRYNIEWICZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

IV. Provider business mailing address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

V. Phone/Fax

Practice location:
  • Phone: 727-462-7907
  • Fax: 727-462-7904
Mailing address:
  • Phone: 727-462-7907
  • Fax: 727-462-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 88151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: