Healthcare Provider Details

I. General information

NPI: 1780305003
Provider Name (Legal Business Name): PATRICIA MARIA SKOWRONEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2479 ALOMA AVE FL 32792
WINTER PARK FL
32792-2541
US

IV. Provider business mailing address

7442 WYNNEWOOD SQ
WINTER PARK FL
32792-6591
US

V. Phone/Fax

Practice location:
  • Phone: 407-657-6692
  • Fax:
Mailing address:
  • Phone: 561-568-3318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: