MEDICARE: MICHAL ZIAJA RN

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
1	163W00000X	Registered Nurse	RN9377123	FL

General Provider Information

NPI Number	:	1578988861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAL ZIAJA RN

Provider Business Mailing Address
First Line	:	4846 MIRAMAR DR
Second Line	:	APT 1306
City	:	MADEIRA BEACH
State	:	FL
Zip	:	33708-3347
Country	:	US
Telephone Number	:	727-678-3543
Fax Number	:

Provider Business Practice Location Address
First Line	:	4846 MIRAMAR DR
Second Line	:	APT 1306
City	:	MADEIRA BEACH
State	:	FL
Zip	:	33708-3347
Country	:	US
Telephone Number	:	727-678-3543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2014
Last Update Date	:	02/24/2014

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