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General NPI Number Information
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NPI Number | 1972046365
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Entity Type | Individual
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Provider Name | KARA ELIZABETH MIERZEJEWSKI PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 4525 S FLORIDA AVE STE 25
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City | LAKELAND
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State | FL
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Zip | 33813-2184
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Country | US
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Telephone | 863-812-4065
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Fax |
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Provider Business Mailing Address
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Address Line | 4525 S FLORIDA AVE STE 25
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City | LAKELAND
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State | FL
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Zip | 33813-2184
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Country | US
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Telephone | 314-322-8507
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2017024080
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP014489T
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT38896
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License Number State | FL
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