Provider Demographics
NPI:1457641219
Name:PAWELEK, BOZENA (DPM)
Entity Type:Individual
Prefix:DR
First Name:BOZENA
Middle Name:
Last Name:PAWELEK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 SW 109TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7385
Mailing Address - Country:US
Mailing Address - Phone:305-752-5592
Mailing Address - Fax:305-752-5593
Practice Address - Street 1:14221 SW 120TH ST
Practice Address - Street 2:SUITE 129
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7236
Practice Address - Country:US
Practice Address - Phone:305-752-5592
Practice Address - Fax:305-752-5593
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3454213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery