Healthcare Provider Details

I. General information

NPI: 1447440458
Provider Name (Legal Business Name): BARBARA H CZELUSNIAK MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38184 MEDICAL CENTER AVE
ZEPHYRHILLS FL
33540-1380
US

IV. Provider business mailing address

38184 MEDICAL CENTER AVE
ZEPHYRHILLS FL
33540-1380
US

V. Phone/Fax

Practice location:
  • Phone: 813-782-1637
  • Fax: 813-780-9664
Mailing address:
  • Phone: 813-782-1637
  • Fax: 813-780-9664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME65298
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME65298
License Number StateFL

VIII. Authorized Official

Name: MISS BARBARA H CZELUSNIAK
Title or Position: OWNER
Credential: MD
Phone: 813-782-1637