Individual
BOGDAN F MALISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 W MAIN ST, MAYO, FL 32066-4127
(386) 294-1226
(386) 294-4218
Mailing address
2804 REMINGTON GREEN CIR STE 2, TALLAHASSEE, FL 32308-1550
(850) 385-4494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME48021
FL
208D00000X
General Practice Physician
Primary
ME48021
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062843300
—
FL
Enumeration date
06/10/2005
Last updated
11/19/2018
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