Provider Demographics
NPI:1366670705
Name:SWARTZLANDER, TY KAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:TY
Middle Name:KAINE
Last Name:SWARTZLANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 N CONGRESS AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8671
Mailing Address - Country:US
Mailing Address - Phone:561-413-2832
Mailing Address - Fax:888-734-6559
Practice Address - Street 1:1880 N CONGRESS AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8671
Practice Address - Country:US
Practice Address - Phone:561-413-2832
Practice Address - Fax:888-734-6559
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 116051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009357600Medicaid
FLPTAN HM211ZMedicare UPIN