Healthcare Provider Details

I. General information

NPI: 1346095809
Provider Name (Legal Business Name): MAGGIE MCSWAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

991 E DEL WEBB BLVD
SUN CITY CENTER FL
33573-6669
US

IV. Provider business mailing address

11340 HUDSON HILLS LN
RIVERVIEW FL
33579-2437
US

V. Phone/Fax

Practice location:
  • Phone: 813-633-5232
  • Fax:
Mailing address:
  • Phone: 803-669-9893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number33123
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: