Healthcare Provider Details

I. General information

NPI: 1588771729
Provider Name (Legal Business Name): NATHANIEL ALLEN SWARTZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15255 MAX LEGGET PKWY STE 5000
JACKSONVILLE FL
32218-7274
US

IV. Provider business mailing address

906 PARK AVE
ORANGE PARK FL
32073-4120
US

V. Phone/Fax

Practice location:
  • Phone: 904-541-0315
  • Fax: 904-541-0316
Mailing address:
  • Phone: 904-541-0315
  • Fax: 904-541-0316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9103840
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: