Healthcare Provider Details

I. General information

NPI: 1003905571
Provider Name (Legal Business Name): ERIC MICHAEL JARYSZAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 S HIAWASSEE RD STE. 103
ORLANDO FL
32835-5718
US

IV. Provider business mailing address

1033 DR MARTIN LUTHER KING JR ST N STE. 108
ST PETERSBURG FL
33701-1547
US

V. Phone/Fax

Practice location:
  • Phone: 407-253-1000
  • Fax: 407-253-1010
Mailing address:
  • Phone: 727-456-4250
  • Fax: 727-346-1044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberME104886
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberTRN7819
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: