Healthcare Provider Details

I. General information

NPI: 1154909067
Provider Name (Legal Business Name): SAMUEL SWARTZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 SOUTHPOINT PKWY STE 300
JACKSONVILLE FL
32216-8203
US

IV. Provider business mailing address

5889 RIVER WAY
GLEN SAINT MARY FL
32040-3323
US

V. Phone/Fax

Practice location:
  • Phone: 904-674-2023
  • Fax:
Mailing address:
  • Phone: 904-477-3087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT36587
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: