Provider Demographics
NPI:1215020706
Name:SZNURKOWSKI, RICHARD-LECH GABRIEL (M D)
Entity Type:Individual
Prefix:DR
First Name:RICHARD-LECH
Middle Name:GABRIEL
Last Name:SZNURKOWSKI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18435 MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-8931
Mailing Address - Country:US
Mailing Address - Phone:941-627-6365
Mailing Address - Fax:
Practice Address - Street 1:18435 MEYER AVE
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-8931
Practice Address - Country:US
Practice Address - Phone:941-627-6365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 29149207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
78968ZOtherMEDICARE PTAN
FLD58599Medicare UPIN