Healthcare Provider Details

I. General information

NPI: 1518451715
Provider Name (Legal Business Name): JOANNE SZEWCZYK BUITRAGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNE BARBARA SZEWCZYK

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-5501
US

IV. Provider business mailing address

PO BOX 100138
GAINESVILLE FL
32610-0138
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-8402
  • Fax: 352-627-4173
Mailing address:
  • Phone: 352-265-8402
  • Fax: 352-627-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME174083
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: