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General NPI Number Information
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NPI Number | 1306165162
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Entity Type | Organization
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Legal Business Name | MICHAEL A WASYLIK MD PA
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 2919 W SWANN AVE SUITE 201
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City | TAMPA
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State | FL
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Zip | 33609-4038
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Country | US
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Telephone | 813-877-9413
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Fax | 813-876-0980
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Provider Business Mailing Address
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Address Line | 2919 W SWANN AVE SUITE 201
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City | TAMPA
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State | FL
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Zip | 33609-4038
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Country | US
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Telephone | 813-877-9413
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Fax | 813-876-0980
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Authorized Official
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Title or Position | ORTHOPAEDIC SURGERY
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Name | DR. MICHAEL A WASYLIK
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Credential | M.D.
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Telephone | 813-877-9413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME 0023025
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License Number State | FL
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