Provider Demographics
NPI:1043212483
Name:OSTROWSKI, EMILY ANN (MD)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ANN
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 SKYTOP DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4165
Mailing Address - Country:US
Mailing Address - Phone:813-530-4585
Mailing Address - Fax:813-605-6053
Practice Address - Street 1:5617 SKYTOP DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-4165
Practice Address - Country:US
Practice Address - Phone:813-530-4585
Practice Address - Fax:813-605-6053
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084597207Q00000X
FLME130676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020742800Medicaid
OH2571355Medicaid
OHH180260Medicare PIN
OHOS4162161Medicare ID - Type Unspecified
OHP00245247OtherRRMC
OH2571355Medicaid
OH04773OtherPARAMOUNT