| Lucas W Maliwacki, PA-C | |
|
4647 Manatee Ave W, Bradenton, FL 34209-3816 | |
| (941) 745-5999 | |
| (941) 745-3555 |
| Full Name | Lucas W Maliwacki |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 4647 Manatee Ave W, Bradenton, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194120535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9108377 (Florida) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| Entity Name | Fl-i Medical Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750655106 PECOS PAC ID: 9133381809 Enrollment ID: O20120426000191 |
| Entity Name | Emergency Medicine Services of FL LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043917180 PECOS PAC ID: 8426413931 Enrollment ID: O20230504001881 |
| Entity Name | Em Alliance LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922788959 PECOS PAC ID: 4789039058 Enrollment ID: O20231006002499 |
| Mailing Address | Practice Location Address |
|---|---|
| Lucas W Maliwacki, PA-C 367 S. Gulph Rd, Att: Ipm Credentialing, King Of Prussia, PA 19406-3121 Ph: (775) 356-9393 | Lucas W Maliwacki, PA-C 4647 Manatee Ave W, Bradenton, FL 34209-3816 Ph: (941) 745-5999 |
Marcie Kroska, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 206 2nd St E, Bradenton, FL 34208 Phone: 941-746-5111 Fax: 941-745-7233 |
Krystina Marian Hadra, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4502 Cortez Rd W Ste 205, Bradenton, FL 34210 Phone: 941-259-8505 Fax: 941-259-8501 |
Mindy Oberley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2010 59th St W Ste 2200, Bradenton, FL 34209 Phone: 941-794-5621 |
Mr. Daniel H Ober, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 315 75th St W, Bradenton, FL 34209 Phone: 941-761-1616 Fax: 941-761-3807 |
Jamie Lee Miller, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8000 Sr 64 E, Bradenton, FL 34212 Phone: 941-792-1404 Fax: 941-761-0712 |
Georgia Ireland, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5318 34th St West, Bradenton, FL 34210 Phone: 941-758-0205 |
Erin N Allendorfer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 206 2nd St E, Bradenton, FL 34208 Phone: 941-746-5111 Fax: 941-745-7233 |