Provider Demographics
NPI:1003934720
Name:WALKOWIAK, EDWARD JOSEPH (RRT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:WALKOWIAK
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2660 NW 105TH LN
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-1040
Mailing Address - Country:US
Mailing Address - Phone:954-465-8009
Mailing Address - Fax:954-473-6502
Practice Address - Street 1:2660 NW 105TH LN
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-1040
Practice Address - Country:US
Practice Address - Phone:954-465-8009
Practice Address - Fax:954-473-6502
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT64002279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health