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General NPI Number Information
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NPI Number | 1568795144
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Entity Type | Organization
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Legal Business Name | WALTER J SZYDLOWSKI JR MD PA
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 11347 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-596-1600
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Fax | 352-596-4655
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Provider Business Mailing Address
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Address Line | 11347 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5404
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Country | US
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Telephone | 352-596-1600
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Fax | 352-596-4655
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Authorized Official
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Title or Position | OWNER/ PRACTITIONER
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Name | WALTER J SZYDLOWSKI JR.
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Credential | MD
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Telephone | 352-596-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME45152
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License Number State | FL
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