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Individual

DR. GERALD A NIEDZWIECKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2730 N MCMULLEN BOOTH RD, SUITE 100, CLEARWATER, FL 33761-3325
(727) 791-7300
(727) 723-9010
Mailing address
2730 N MCMULLEN BOOTH RD, STE 100, CLEARWATER, FL 33761-3302
(727) 791-7300
(727) 723-9010

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME0070649
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME0070649
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1600774
UNITED HEALTHCARE
FL
05
250195300
FL
01
2648373
AETNA HMO
FL
01
31439
BLUE CROSS BLUE SHIELD
FL
01
4595565
AETNA PPO
FL
Enumeration date
11/07/2006
Last updated
05/09/2017
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