Healthcare Provider Details

I. General information

NPI: 1962341578
Provider Name (Legal Business Name): ALICIA CHECHELE WALCZYNSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 S FALKENBURG RD
RIVERVIEW FL
33578-2574
US

IV. Provider business mailing address

3140 S FALKENBURG RD
RIVERVIEW FL
33578-2574
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7585
  • Fax:
Mailing address:
  • Phone: 813-844-7585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number11044679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: