Healthcare Provider Details

I. General information

NPI: 1528120664
Provider Name (Legal Business Name): STANLEY EUGENE SWIHART NMD, DOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11309 LOUISA MAY WAY
RIVERVIEW FL
33569-5520
US

IV. Provider business mailing address

11309 LOUISA MAY WAY
RIVERVIEW FL
33569-5520
US

V. Phone/Fax

Practice location:
  • Phone: 813-672-3627
  • Fax:
Mailing address:
  • Phone: 813-672-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP1678
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNAT1000686
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: