Provider Demographics
NPI:1376687376
Name:SROKA, MALGORZATA (A P)
Entity Type:Individual
Prefix:MRS
First Name:MALGORZATA
Middle Name:
Last Name:SROKA
Suffix:
Gender:F
Credentials:A P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 SW 124TH AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4606
Mailing Address - Country:US
Mailing Address - Phone:305-412-1041
Mailing Address - Fax:
Practice Address - Street 1:19 W FLAGLER ST
Practice Address - Street 2:STE 906
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-4407
Practice Address - Country:US
Practice Address - Phone:305-375-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1409171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist