Provider Demographics
NPI:1790876340
Name:SADLOWSKI, YOLANTA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:YOLANTA
Middle Name:
Last Name:SADLOWSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 6TH ST S STE 430
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4825
Mailing Address - Country:US
Mailing Address - Phone:727-767-4149
Mailing Address - Fax:
Practice Address - Street 1:880 6TH ST S STE 430
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4825
Practice Address - Country:US
Practice Address - Phone:727-767-4149
Practice Address - Fax:727-767-4294
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101435363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291945100Medicaid