Provider Demographics
NPI:1497964746
Name:JANECZEK, KINGA (MD)
Entity Type:Individual
Prefix:DR
First Name:KINGA
Middle Name:
Last Name:JANECZEK
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 1:346 PENINSULA ISLAND PT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-6323
Mailing Address - Country:US
Mailing Address - Phone:727-544-0404
Mailing Address - Fax:727-544-4040
Practice Address - Street 1:5000 PARK ST N
Practice Address - Street 2:SUITE 1020
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709
Practice Address - Country:US
Practice Address - Phone:727-544-0404
Practice Address - Fax:727-544-4040
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine