Individual
TADEUSZ CISZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1305 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4542
(863) 688-2334
Mailing address
1364 CLIFTON RD NE, ROOM D125A, ATLANTA, GA 30322-1059
(404) 712-4686
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME140982
FL
2085R0204X
Vascular & Interventional Radiology Physician
13521
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100079591
—
WI
Enumeration date
05/10/2013
Last updated
06/24/2025
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