Provider Demographics
NPI:1932313186
Name:JANUARIUSZ L. STYPEREK MD PA
Entity Type:Organization
Organization Name:JANUARIUSZ L. STYPEREK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-732-1586
Mailing Address - Street 1:2314 S SEACREST BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6788
Mailing Address - Country:US
Mailing Address - Phone:561-732-1586
Mailing Address - Fax:561-732-3160
Practice Address - Street 1:2314 S SEACREST BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6788
Practice Address - Country:US
Practice Address - Phone:561-732-1586
Practice Address - Fax:561-732-3160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0027142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL035128800Medicaid
FL93360OtherBCBS OF FL
FL110013019OtherPALMETTO GBA
FL035128800Medicaid
FLK3914Medicare ID - Type UnspecifiedGROUP #
FLE12065Medicare UPIN