Provider Demographics
NPI:1194811646
Name:STYPEREK, JANUARIUSZ L (MD)
Entity type:Individual
Prefix:DR
First Name:JANUARIUSZ
Middle Name:L
Last Name:STYPEREK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 S SEACREST BLVD SUITE 102
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6788
Mailing Address - Country:US
Mailing Address - Phone:561-732-1586
Mailing Address - Fax:561-732-3160
Practice Address - Street 1:2314 S SEACREST BLVD SUITE 102
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6788
Practice Address - Country:US
Practice Address - Phone:561-732-1586
Practice Address - Fax:561-732-3160
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27142207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE12065Medicare UPIN
FL93360XMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL PROV#
FLK3914Medicare ID - Type UnspecifiedMEDICARE GROUP #
FL93360WMedicare PIN