| Doctor Name: | DR. HENRYK T MALCZAK |
| NPI Number: | 1912008145 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O |
| License Number: | OS6110 |
| Business Practice Address: | 2500 Citrus Blvd Leesburg, FL - 347483063 |
| Business Phone Number: | 3523475225 |
| Business Fax Number: | 3523471073 |
| Mailing Address: | 2500 Citrus Blvd, LEESBURG |
| State: | FL |
| Postal Code: | 347483063 |
| Phone Number: | 3523475225 |
| Fax Number: | 3523471073 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 03/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS6110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |