Healthcare Provider Details

I. General information

NPI: 1821568825
Provider Name (Legal Business Name): MAGDALENA KINGA SKOWRONSKA MSN, APRN, FNP-C, CE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 COLUMBIA BLVD STE A108
TITUSVILLE FL
32780-7864
US

IV. Provider business mailing address

8 MIRROR LAKE DR STE A
ORMOND BEACH FL
32174-3102
US

V. Phone/Fax

Practice location:
  • Phone: 321-264-9176
  • Fax: 321-636-1731
Mailing address:
  • Phone: 386-673-2500
  • Fax: 386-673-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberAPRN11000302
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11000302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: