Basic Information
| Provider Information | |||||||||
| NPI: | 1821054974 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEJMEJ | ||||||||
| FirstName: | RYSZARDA | ||||||||
| MiddleName: | MALGORZATA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 2147 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339022147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393432052 | ||||||||
| FaxNumber: | 2393435348 | ||||||||
| Practice Location | |||||||||
| Address1: | 9981 S HEALTHPARK DR | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393432052 | ||||||||
| FaxNumber: | 2393435348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 11/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME101103 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | E-1411 | AR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME101103 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 000490000 | 05 | FL | MEDICAID | 132914001 | 05 | AR | MEDICAID | 53345 | 01 | FL | BCBSFL | OTHER |