Provider Demographics
NPI:1033664354
Name:SOWINSKI, STANISLAW ANTHONY JR (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:STANISLAW
Middle Name:ANTHONY
Last Name:SOWINSKI
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 SW 82ND CT.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143
Mailing Address - Country:US
Mailing Address - Phone:305-491-4039
Mailing Address - Fax:
Practice Address - Street 1:15150 BULL RUN RD
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2167
Practice Address - Country:US
Practice Address - Phone:305-364-0969
Practice Address - Fax:305-364-0937
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31473174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT31473OtherPHYSICAL THERAPY LICENSE