Provider Demographics
NPI:1356488068
Name:ROBERT A ZURAWIECKI MD PA
Entity Type:Organization
Organization Name:ROBERT A ZURAWIECKI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ZURAWIECKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-554-0079
Mailing Address - Street 1:12955 SW 42ND ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2920
Mailing Address - Country:US
Mailing Address - Phone:305-554-0079
Mailing Address - Fax:
Practice Address - Street 1:12955 SW 42ND ST
Practice Address - Street 2:SUITE 10
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2920
Practice Address - Country:US
Practice Address - Phone:305-554-0079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ795Medicare PIN
FLD59911Medicare UPIN