Healthcare Provider Details

I. General information

NPI: 1477999100
Provider Name (Legal Business Name): SWAIN MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7790 NW 7TH AVE
MIAMI FL
33150-3262
US

IV. Provider business mailing address

7790 NW 7TH AVE
MIAMI FL
33150-3262
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-7930
  • Fax: 786-953-6911
Mailing address:
  • Phone: 786-953-7930
  • Fax: 786-953-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11248
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number11248
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHCC8984
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number11248
License Number StateFL

VIII. Authorized Official

Name: MR. ANTHONY V SWAIN
Title or Position: CEO
Credential:
Phone: 786-953-7930