Healthcare Provider Details

I. General information

NPI: 1194656686
Provider Name (Legal Business Name): WIKTORIA MAGDALENA PRZESTRZELSKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 N DALE MABRY HWY STE 102
TAMPA FL
33618-4421
US

IV. Provider business mailing address

7409 PALMERA POINTE CIR UNIT 201
TAMPA FL
33615-2930
US

V. Phone/Fax

Practice location:
  • Phone: 813-851-0742
  • Fax:
Mailing address:
  • Phone: 727-307-4742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: