Basic Information
| Provider Information | |||||||||
| NPI: | 1609830488 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAWORSKI | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4631 NW 31ST AVE | ||||||||
| Address2: | C/O ANESCO ANESTHESIA ASSOCIATES INC | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333093433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544855666 | ||||||||
| FaxNumber: | 9544841651 | ||||||||
| Practice Location | |||||||||
| Address1: | 5757 N DIXIE HWY | ||||||||
| Address2: | C/O NORTH RIDGE MEDICAL CENTER | ||||||||
| City: | OAKLAND PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333344135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547766000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | OS7664 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.