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General NPI Number Information
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NPI Number | 1679541999
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH KRZYZKOWSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/11/2006
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 5955 RAND BLVD. TIDEWELL HOSPICE AND PALLIATIVE CARE
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City | SARASOTA
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State | FL
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Zip | 34238-5160
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Country | US
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Telephone | 941-923-5822
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Fax | 941-925-0969
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Provider Business Mailing Address
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Address Line | 5955 RAND BLVD. TIDEWELL HOSPICE AND PALLIATIVE CARE
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City | SARASOTA
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State | FL
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Zip | 34238-5160
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Country | US
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Telephone | 941-923-5822
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Fax | 941-925-0969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME91548
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License Number State | FL
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