Healthcare Provider Details

I. General information

NPI: 1760530828
Provider Name (Legal Business Name): DANIEL STEVEN CZERWINSKI PT AP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6075 SUNSET DR SUITE 203
SOUTH MIAMI FL
33143-5000
US

IV. Provider business mailing address

15121 SW 87TH AVE
VILLAGE OF PALMETTO BAY FL
33176-8054
US

V. Phone/Fax

Practice location:
  • Phone: 305-962-3240
  • Fax: 305-235-8724
Mailing address:
  • Phone: 305-962-3240
  • Fax: 305-235-8724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 461
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 3806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: