Provider Demographics
NPI:1508899055
Name:ZEMANKIEWICZ, STAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STAN
Middle Name:
Last Name:ZEMANKIEWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 OSPREY BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-4340
Mailing Address - Country:US
Mailing Address - Phone:813-643-8906
Mailing Address - Fax:813-643-8906
Practice Address - Street 1:2250 OSPREY BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-4340
Practice Address - Country:US
Practice Address - Phone:813-643-8906
Practice Address - Fax:813-643-8906
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047215207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE34368Medicare UPIN
FL01454Medicare ID - Type Unspecified