Organization
INFECTIOUS DISEASES CONSULTANTS, P.A.
Active
Other names
Tomasz K. Wazny, MD, PA
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN RICHARD (OFFICE MANAGER)
(941) 613-2800
Entity
Organization
Contact information
Practice address
21205 OLEAN BLVD STE A, PORT CHARLOTTE, FL 33952-6756
(941) 613-2800
(941) 613-2801
Mailing address
21205 OLEAN BLVD STE A, PORT CHARLOTTE, FL 33952-6756
(941) 613-2800
(941) 613-2801
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME0056397
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271223700
—
FL
01
—
440002698
RR MEDICARE
FL
01
—
P00338188
RR MEDICARE
FL
Enumeration date
10/11/2006
Last updated
02/08/2022
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