Healthcare Provider Details

I. General information

NPI: 1235005695
Provider Name (Legal Business Name): JOSEPH PAWELEZYKE REGISTERED NURSE BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S DETROIT AVE
TOLEDO OH
43614-5903
US

IV. Provider business mailing address

1296 VALETTA DR
TEMPERANCE MI
48182-2608
US

V. Phone/Fax

Practice location:
  • Phone: 419-259-2000
  • Fax:
Mailing address:
  • Phone: 734-847-2307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN9183870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: