Healthcare Provider Details

I. General information

NPI: 1164650016
Provider Name (Legal Business Name): MICHAEL SWARTZON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 CAMPO SANO AVE
CORAL GABLES FL
33146-1174
US

IV. Provider business mailing address

PO BOX 100905
ATLANTA GA
30384-0905
US

V. Phone/Fax

Practice location:
  • Phone: 786-268-6200
  • Fax: 786-533-9977
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME111089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: