Provider Demographics
NPI:1801819578
Name:ROZWADOWSKI, FAYE (MD)
Entity Type:Individual
Prefix:DR
First Name:FAYE
Middle Name:
Last Name:ROZWADOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FAYE
Other - Middle Name:
Other - Last Name:BRADFISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2181 ORANGE AVE E
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-6144
Mailing Address - Country:US
Mailing Address - Phone:850-513-7059
Mailing Address - Fax:
Practice Address - Street 1:2181 ORANGE AVE E
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-6144
Practice Address - Country:US
Practice Address - Phone:850-513-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI52220-020207Q00000X
FLVAD0000207Q00000X
FLME1398952083P0901X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine