Healthcare Provider Details

I. General information

NPI: 1952025165
Provider Name (Legal Business Name): CAROL J SWABY ARNP-A-GNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6087 ADRIATIC WAY
GREENACRES FL
33413-1094
US

IV. Provider business mailing address

6087 ADRIATIC WAY
GREENACRES FL
33413-1094
US

V. Phone/Fax

Practice location:
  • Phone: 561-396-3496
  • Fax:
Mailing address:
  • Phone: 561-396-3496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11022379
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11022379
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: