# KIELISZAK MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205730033
- **Authorized official:** CHRISTOPHER KIELISZAK DO (OWNER)
- **Authorized official phone:** (813) 434-3238

## Contact information

- **Practice address:** 801 2ND ST N STE D, SAFETY HARBOR, FL 34695-3503
- **Practice address phone:** (813) 563-3735
- **Practice address fax:** (813) 725-9819
- **Mailing address:** 801 2ND ST N STE D, SAFETY HARBOR, FL 34695-3503
- **Mailing address phone:** (813) 563-3735
- **Mailing address fax:** (813) 725-9819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |

## Other

- **Enumeration date:** 10/05/2026
- **Last updated:** 10/05/2026