Basic Information
| Provider Information | |||||||||
| NPI: | 1093899981 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAWLOSKI | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D., PH. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10740 PALM RIVER RD | ||||||||
| Address2: | STE 360 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336194578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024064786 | ||||||||
| FaxNumber: | 9166364358 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 N 6TH ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850042155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024068222 | ||||||||
| FaxNumber: | 6024060663 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 11/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0000X | 064441 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0000X | MD431888 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0000X | ME147761 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0003X | 55891 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | P00925246 | 01 | RR MEDICARE | OTHER | 119627 | 01 | AL | ALABAMA MEDICAID | OTHER | 52497585 001 | 01 | GA | BCBS/GA | OTHER | 2756281 | 05 | OH | MEDICAID | 602-01627 | 01 | AL | BCBS/AL | OTHER | 1019279400001 | 05 | PA | MEDICAID | 1840102000 | 05 | WV | MEDICAID | 304832075A | 05 | GA | MEDICAID |