Provider Demographics
NPI:1437307055
Name:ZAWADA, MARY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:ZAWADA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 WEDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-9318
Mailing Address - Country:US
Mailing Address - Phone:352-259-2225
Mailing Address - Fax:352-259-4411
Practice Address - Street 1:3614 WEDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-9318
Practice Address - Country:US
Practice Address - Phone:352-259-2225
Practice Address - Fax:352-259-4411
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22150OtherBCBS
FLIM372ZMedicare PIN