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Individual

ELZBIETA KOLANKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2501 W KENNEDY BLVD, TAMPA, FL 33609
(813) 844-1385
Mailing address
2501 W KENNEDY BLVD, TAMPA, FL 33609

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME125513
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015879700
FL
01
036-115103
STATE LICENSE
IL
05
036115103
IL
01
11869039
CAQH
01
FK0769058
DEA
01
ME 125513
LICENSE
FL
Enumeration date
08/14/2006
Last updated
09/27/2023
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