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Individual

SCOTT M KOWALSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1564 KINGSLEY AVE, ORANGE PARK, FL 32073-4521
(904) 264-8801
(904) 621-0566
Mailing address
3717 WESTOVER RD, FLEMING ISLAND, FL 32003-7107
(517) 896-1375

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
5101016005
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
OS16975
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
108927900
FL
05
1891729166
MI
Enumeration date
07/10/2006
Last updated
08/02/2023
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