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NPI Code Detail

MEDICARE: JILL MALISZEWSKI

MEDICARE: JILL MALISZEWSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental TherapistFL
2235Z00000XSpeech-Language PathologistSA6455FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S2331OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114094661
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL MALISZEWSKI
Provider Business Mailing Address
First Line : 3663 CROWN POINT CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-5967
Country : US
Telephone Number : 904-288-8910
Fax Number : 904-288-8912
Provider Business Practice Location Address
First Line : 12276 SAN JOSE BLVD STE 507
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-8618
Country : US
Telephone Number : 904-288-8910
Fax Number : 904-288-8912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 08/23/2022

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Directions to “ JILL MALISZEWSKI ” Practice Location

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