Provider Demographics
NPI:1548559214
Name:DOCTORS CLINIC FAMILY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:DOCTORS CLINIC FAMILY HEALTH CENTER, LLC
Other - Org Name:STANLEY H SWEDA, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-763-1107
Mailing Address - Street 1:204 SE PARK ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2967
Mailing Address - Country:US
Mailing Address - Phone:863-763-1107
Mailing Address - Fax:863-763-2630
Practice Address - Street 1:204 SE PARK ST
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2967
Practice Address - Country:US
Practice Address - Phone:863-763-1107
Practice Address - Fax:863-763-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0045700208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty