Provider Demographics
NPI:1629067160
Name:OSTRZENSKA, KATARZYNA MARIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:KATARZYNA
Middle Name:MARIA
Last Name:OSTRZENSKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATARZYNA
Other - Middle Name:MARIA
Other - Last Name:BAGHERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7001 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-7549
Mailing Address - Country:US
Mailing Address - Phone:727-343-6606
Mailing Address - Fax:727-341-0121
Practice Address - Street 1:7001 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-7549
Practice Address - Country:US
Practice Address - Phone:727-343-6606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH27838Medicare UPIN