Provider Demographics
NPI:1568534337
Name:MLYNARCZYK, EWA MONIKA (PT)
Entity Type:Individual
Prefix:MS
First Name:EWA
Middle Name:MONIKA
Last Name:MLYNARCZYK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-5602
Mailing Address - Country:US
Mailing Address - Phone:718-302-0456
Mailing Address - Fax:
Practice Address - Street 1:12159 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8678
Practice Address - Country:US
Practice Address - Phone:941-776-5585
Practice Address - Fax:941-776-5655
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist