Provider Demographics
NPI:1023217502
Name:JANECZEK, LUKASZ K (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKASZ
Middle Name:K
Last Name:JANECZEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 PENINSULA ISLAND PT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-6323
Mailing Address - Country:US
Mailing Address - Phone:831-442-3100
Mailing Address - Fax:
Practice Address - Street 1:346 PENINSULA ISLAND PT
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-6323
Practice Address - Country:US
Practice Address - Phone:407-923-2133
Practice Address - Fax:407-960-3266
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105378207PE0004X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1748200Medicaid