Provider Demographics
NPI:1871544411
Name:CHMIELEWSKI, I LISA (MD)
Entity type:Individual
Prefix:DR
First Name:I
Middle Name:LISA
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1921 WALDEMERE STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239
Mailing Address - Country:US
Mailing Address - Phone:941-806-0540
Mailing Address - Fax:941-806-0543
Practice Address - Street 1:1921 WALDEMERE STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-806-0540
Practice Address - Fax:941-806-0543
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2010-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0073458207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03294Medicare UPIN