Provider Demographics
NPI:1750526273
Name:CHUDZINSKI, ALLEN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:PAUL
Last Name:CHUDZINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4680
Mailing Address - Country:US
Mailing Address - Phone:813-615-7366
Mailing Address - Fax:
Practice Address - Street 1:3000 MEDICAL PARK DR
Practice Address - Street 2:SUITE 500
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4680
Practice Address - Country:US
Practice Address - Phone:813-615-7366
Practice Address - Fax:813-615-8008
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD037945208C00000X
FLME126841208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016787200Medicaid
FLKVWWLOtherBCBS