Active NPI
Magdalena Iwanek
- Physical Therapist
- Lakeland, FL
National Provider Identifier
1619216298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 12969
- Practice address
- 2020 W Lake Parker Dr
Lakeland, FL 33805-5005 - Phone
- (863) 603-6811
- NPI assigned
- Feb 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 12969 | FL | Primary |
Addresses
Primary practice location
2020 W Lake Parker Dr
Lakeland, FL 33805-5005
Mailing address
5412 River Rock Rd
Lakeland, FL 33809-0960
Phone (863) 608-0446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 12969 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359763200000",
"number": "1619216298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5412 RIVER ROCK RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338090960",
"telephone_number": "863-608-0446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 W LAKE PARKER DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338055005",
"telephone_number": "863-603-6811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWANEK",
"first_name": "MAGDALENA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-02",
"last_updated": "2013-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 12969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.