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Individual

ANA CECILIA CISZEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1287 US HIGHWAY 41 BYP S, VENICE, FL 34285-5545
(941) 202-0500
(941) 202-0501
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
(239) 599-2612

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45787
AZ
207R00000X
Internal Medicine Physician
Primary
ME136155
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024710700
FL
05
724801
AZ
01
JJ085Z
MEDICARE
FL
01
QV4EL
FLORIDA BLUE
FL
01
Z188453
MEDICARE PTAN
AZ
Enumeration date
07/06/2012
Last updated
08/25/2020
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