Healthcare Provider Details

I. General information

NPI: 1922033968
Provider Name (Legal Business Name): DEBRA SWABY MCNEIL P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL PRIMARY CARE (110)
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

16103 82ND RD N
LOXAHATCHEE FL
33470-3138
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-7577
  • Fax: 561-422-7615
Mailing address:
  • Phone: 561-422-7577
  • Fax: 561-422-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2603
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: