Provider Demographics
NPI:1477721587
Name:J. KEVIN SCHWENINGER, DO PA
Entity Type:Organization
Organization Name:J. KEVIN SCHWENINGER, DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWENINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-549-2105
Mailing Address - Street 1:6036 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3228
Mailing Address - Country:US
Mailing Address - Phone:727-549-2105
Mailing Address - Fax:727-768-0488
Practice Address - Street 1:6036 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3228
Practice Address - Country:US
Practice Address - Phone:727-549-2105
Practice Address - Fax:727-768-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5437207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE31897Medicare UPIN
FL3944300001Medicare NSC