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General NPI Number Information
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NPI Number | 1841505492
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Entity Type | Organization
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Legal Business Name | STANLEY D ROWICKI MD PA
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 800 PRUDENTIAL DR
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8202
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Country | US
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Telephone | 904-343-8982
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Fax | 904-281-9806
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Provider Business Mailing Address
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Address Line | 4521 ATLANTIC BLVD SUITE C
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City | JACKSONVILLE
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State | FL
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Zip | 32207-1137
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Country | US
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Telephone | 904-343-8982
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Fax | 904-281-9806
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANLEY D ROWICKI
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Credential | MD
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Telephone | 904-343-8982
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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 | ME74890
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License Number State | FL
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