Healthcare Provider Details

I. General information

NPI: 1154663789
Provider Name (Legal Business Name): FRANCIS JOHN WOJCIK JR. B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2789 ORTIZ AVE
FORT MYERS FL
33905-7806
US

IV. Provider business mailing address

1735 BRANTLEY RD APT. 1514
FORT MYERS FL
33907-3995
US

V. Phone/Fax

Practice location:
  • Phone: 239-791-1586
  • Fax:
Mailing address:
  • Phone: 845-443-9429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: