DR. HENRYK T MALCZAK D.O
NPI 1912008145
General Practice in Winter Haven, FL

Q: What is Henryk Malczak's NPI number?

The NPI number for Henryk Malczak is 1912008145. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Q: What is Henryk Malczak's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Henryk Malczak was last updated on May 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 26, 2006PECOS Enrolled

550 POPE AVE NW STE 200, WINTER HAVEN, FL 33881(863) 299-2630(407) 285-4515 Get Directions Write a Review

NPPES record last updated: May 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 17, 2024, Aug 14, 2023 (2 updates tracked since 2023).

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About Dr. Henryk T Malczak D.o NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. HENRYK T MALCZAK D.O (NPI 1912008145) is an individual general practice provider in Winter Haven, Florida, licensed in Florida (OS6110) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Leesburg.

NPPES Registry Identity

NPI1912008145

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. HENRYK T MALCZAKCredential: D.O

Location Address550 POPE AVE NW STE 200Winter Haven, FL 33881-4679

Mailing Address425 W Colonial Dr Ste 303Orlando, FL 32804-6863 · (321) 332-6947 · Fax (407) 286-4515

Phone(863) 299-2630

Fax(407) 285-4515

Sole ProprietorNo

Enumeration DateSeptember 26, 2006

Last NPPES UpdateMay 17, 20242 updates tracked since enumeration

NPPES CertifiedMay 17, 2024

✔ NPI 1912008145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in FL · OS6110

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

550 POPE AVE NW STE 200, Winter Haven, FL 33881

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Secondary Practice Location 1

Location 12500 Citrus BlvdLeesburg, FL 34748-3063 · Phone (352) 347-5225 · Fax (352) 347-1073

Other Identifiers 1

OtherOS6110FL · Florida Osteopathic Licen

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Henryk T Malczak D.o is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH MARGARET ENNIS PA-C

Physician Assistant