Provider Demographics
NPI:1689611253
Name:KRAWCZYK, DAVID (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KRAWCZYK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 W MICHIGAN ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4465
Mailing Address - Country:US
Mailing Address - Phone:407-888-2255
Mailing Address - Fax:407-888-2446
Practice Address - Street 1:104 PARK PLACE BLVD STE B
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6866
Practice Address - Country:US
Practice Address - Phone:863-547-9793
Practice Address - Fax:863-547-9794
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY023HZMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #