Provider Demographics
NPI:1043090442
Name:CZERWIEN, LUKASZ MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:LUKASZ
Middle Name:MICHAEL
Last Name:CZERWIEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 3RD ST S UNIT 810
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4647
Mailing Address - Country:US
Mailing Address - Phone:727-424-0174
Mailing Address - Fax:
Practice Address - Street 1:1528 LAKEVIEW RD STE 150
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3694
Practice Address - Country:US
Practice Address - Phone:727-408-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor