Healthcare Provider Details

I. General information

NPI: 1528387065
Provider Name (Legal Business Name): JANUSZ HENRYK SWIATKOWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S FEDERAL HWY
BOYNTON BEACH FL
33435-4931
US

IV. Provider business mailing address

8822 INDIAN RIVER RUN
BOYNTON BEACH FL
33472-2444
US

V. Phone/Fax

Practice location:
  • Phone: 954-487-1224
  • Fax:
Mailing address:
  • Phone: 561-292-3365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number208857
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: