Provider Demographics
NPI:1174835805
Name:JOHN E SWIFT MD PA
Entity Type:Organization
Organization Name:JOHN E SWIFT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-665-2023
Mailing Address - Street 1:9200 BONITA BEACH RD SE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4280
Mailing Address - Country:US
Mailing Address - Phone:239-992-2494
Mailing Address - Fax:239-992-2495
Practice Address - Street 1:7000 SW 97TH AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1494
Practice Address - Country:US
Practice Address - Phone:305-665-2023
Practice Address - Fax:305-665-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME13112207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048195500Medicaid
FLD61661Medicare UPIN