=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093033409
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEROME P. SWEITZER D.C., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2010
-----------------------------------------------------
Last Update Date | 11/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 611 N WYMORE RD STE 98
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32789-2848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-422-5916
-----------------------------------------------------
Fax | 407-853-4829
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 611 N WYMORE RD STE 98
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32789-2848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-422-5916
-----------------------------------------------------
Fax | 407-853-4829
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JEROME P. SWEITZER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 407-422-5916
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------