Provider Demographics
NPI:1659429223
Name:CZAYKOWSKY, GUY RICHARD
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:RICHARD
Last Name:CZAYKOWSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5224 W STATE ROAD 46
Mailing Address - Street 2:UNIT 238
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9230
Mailing Address - Country:US
Mailing Address - Phone:386-236-3210
Mailing Address - Fax:386-236-3135
Practice Address - Street 1:1220 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2810
Practice Address - Country:US
Practice Address - Phone:386-236-3210
Practice Address - Fax:386-236-3135
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 562012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE62388Medicare UPIN