MEDICARE: ANNA WASILEWSKA

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1629786165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA WASILEWSKA

Provider Business Mailing Address
First Line	:	29228 US 19 N
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33761-2101
Country	:	US
Telephone Number	:	727-351-4191
Fax Number	:

Provider Business Practice Location Address
First Line	:	10901 BRIGHTON BAY BLVD NE APT 6214
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33716-3455
Country	:	US
Telephone Number	:	727-922-4483
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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Directions to “ ANNA WASILEWSKA ” Practice Location

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