Individual
JACEK HENRYK PIETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1726 MEDICAL BLVD STE 101, NAPLES, FL 34110-1426
(239) 624-8250
(239) 624-8251
Mailing address
311 9TH ST. N., SUITE 304, NAPLES, FL 34102
(239) 624-8250
(239) 624-8251
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036087837
IL
207R00000X
Internal Medicine Physician
ME153904
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036087837
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME153904
FL
207RP1001X
Pulmonary Disease Physician
036087837
IL
207RP1001X
Pulmonary Disease Physician
Primary
ME153904
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215074
BLUE SHIELD PROVIDER NUMB
IL
05
—
036087837
—
IL
05
—
118420400
—
FL
Enumeration date
05/02/2006
Last updated
08/01/2024
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