MEDICARE: CHRISTINE KOWALSKI

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1902431968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE KOWALSKI

Provider Business Mailing Address
First Line	:	5051 CASTELLO DR STE 4
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-8959
Country	:	US
Telephone Number	:	239-228-5351
Fax Number	:	239-228-5349

Provider Business Practice Location Address
First Line	:	5051 CASTELLO DR STE 4
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-8959
Country	:	US
Telephone Number	:	239-228-5351
Fax Number	:	239-228-5349

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

Provider Enumeration Date	:	03/10/2020
Last Update Date	:	03/10/2020

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Directions to “ CHRISTINE KOWALSKI ” Practice Location

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