LUCAS W MALIWACKI (NPI# 1194120535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194120535 |
| Entity Type | Individual |
| Full Name | LUCAS W MALIWACKI |
| Credential | PA-C |
| Practice Address |
4647 Manatee Ave W Bradenton FL 34209-3816 |
| Mailing Address |
367 S. Gulph Rd Att: Ipm Credentialing King of Prussia PA 19406-3121 |
| Practice Telephone | 9417455999 |
| Practice Fax Number | 9417453555 |
| Mailing Telephone | 7753569393 |
| Mailing Fax Number | 7753565590 |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2017-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9108377 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4647 MANATEE AVE W |
| City | BRADENTON |
| State | FL |
| Zip Code | 34209-3816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346271699 | Asha Munshi | Family Medicine | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2006-07-05 |
| 1477174456 | Manatee Urgent Care LLC | Clinic/Center | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2020-05-01 |
| 1881240273 | Marilyn Leann Waters | Nurse Practitioner | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2019-08-13 |
| 1831654771 | Manatee Physician Alliance, LLC | Nurse Practitioner | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2019-02-05 |
| 1689148306 | Victoria Crittenden | Physician Assistant | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2019-01-15 |
| 1982144242 | Angel Wasson | Nurse Practitioner | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2017-03-06 |
| 1437595782 | Guy Guimond | Physician Assistant | 4647 Manatee Ave W, Bradenton, FL 34209 | 2013-05-14 |
| 1396997532 | Lakewood Ranch Urgent Care, Pa | Clinic/Center | 4647 Manatee Ave W, Bradenton, FL 34209-3849 | 2008-10-21 |
| 1154513364 | Michael John Austen | Family Medicine | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2007-08-11 |
| 1053453878 | Kathleen M Welch-wilson | Family Medicine | 4647 Manatee Ave W, Bradenton, FL 34209-3816 | 2007-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740828029 | Cairn Clinic, LLC | Massage Therapist | 4701 Manatee Ave. West, Bradenton, FL 34209 | 2019-12-17 |
| 1790341782 | Kyle James Van Benschoten | Physical Therapist | Casa Mora Rehabilitation, Bradenton, FL 34209 | 2019-05-15 |
| 1336679117 | Jennifer Rose Patterson | Nurse Practitioner | 7211 6th Ave Nw, Bradenton, FL 34209 | 2017-06-14 |
| 1972872604 | Manatee Diagnostic Center West | Radiology | 2211 60th St West, Bradenton, FL 34209 | 2011-12-27 |
| 1235406646 | Manatee Diagnostic Center,ltd | Radiology | 2301 60th Street Court West, Suite C, Bradenton, FL 34209 | 2011-11-30 |
| 1073830758 | Melissa Anderson | Occupational Therapy Assistant | 5203 12th Ave Drive West, Bradenton, FL 34209 | 2010-04-21 |
| 1205060993 | Margaret Ann Kirkland | Dentist | 2902 59th St. W., Suite V, Bradenton, FL 34209 | 2009-05-08 |
| 1477791028 | Anna Maria Chiropractic Pllc | Chiropractor | 7315 9th Ave N.w., Bradenton, FL 34209 | 2009-02-04 |
| 1174783393 | The Lombardo Home | Assisted Living Facility | 620 71st Street North West, Bradenton, FL 34209 | 2008-06-11 |
| 1407041072 | Allison Jean Kelly | Occupational Therapist | 5949 17th Avenue W, Bradenton, FL 34209 | 2007-09-07 |
| Find all providers in zip 34209 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141814 | Michi Cristina Carlsson | Physician Assistant | 231 Sun Isle Cir Unit 308, Bradenton, FL 34208-2728 | 2020-07-20 |
| 1154945178 | Dana J Scott | Physician Assistant | 9826 18th Dr Nw, Bradenton, FL 34209-8102 | 2020-06-05 |
| 1275162216 | Regina Marie Aluise | Physician Assistant | 7710 Camden Harbour Dr, Bradenton, FL 34212-9311 | 2020-04-02 |
| 1932750197 | Victor Zavala More | Physician Assistant | 200 3rd Ave W Ste 100, Bradenton, FL 34205-8628 | 2019-09-27 |
| 1083175236 | Nisha Patel | Physician Assistant | 2902 59th St W Ste C, Bradenton, FL 34209-7021 | 2019-03-29 |
| 1346735719 | Jessica Levanti | Physician Assistant | 714 Manatee Ave E Ste A, Bradenton, FL 34208-1235 | 2018-06-27 |
| 1104337294 | Desoto Lakes Emergency Physicians LLC | Physician Assistant | 8500 Sr 70 East, Bradenton, FL 34202 | 2017-10-17 |
| 1902216716 | Julie Chorley | Physician Assistant | 232 Manatee Ave E, Bradenton, FL 34208 | 2014-05-01 |
| 1841221678 | David Hervig | Physician Assistant | 9908 Sr 64 East, Bradenton, FL 34212-5303 | 2006-07-06 |
| 1861437915 | Loretta J Putvin-golding | Physician Assistant | 5309 Sr 64 E, Bradenton, FL 34208 | 2006-06-20 |
| Find all providers in BRADENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.