Provider Demographics
NPI:1417029869
Name:PULAWSKI, ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:PULAWSKI
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 1:5801 BRADEN RUN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9402
Mailing Address - Country:US
Mailing Address - Phone:941-727-1500
Mailing Address - Fax:941-727-1509
Practice Address - Street 1:5801 BRADEN RUN
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-9402
Practice Address - Country:US
Practice Address - Phone:941-727-1500
Practice Address - Fax:941-727-1509
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036071954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071954OtherSTATE LICENSE
FL623540OtherSTATE LICENCE