Basic Information
| Provider Information | |||||||||
| NPI: | 1437388006 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CZAK | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 943 S BENEVA RD STE 306 | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342322473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419544440 | ||||||||
| FaxNumber: | 9419544440 | ||||||||
| Practice Location | |||||||||
| Address1: | 11715 RANGELAND PKWY | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342119529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415380088 | ||||||||
| FaxNumber: | 9415380089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2009 | ||||||||
| LastUpdateDate: | 09/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | OS016590 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RI0011X | OS17749 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.