Provider Demographics
NPI:1598401887
Name:SWEENEY, ANN (RA)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:RA
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:VACCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RA
Mailing Address - Street 1:2202 S CRANBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3018
Mailing Address - Country:US
Mailing Address - Phone:440-787-8138
Mailing Address - Fax:
Practice Address - Street 1:2202 S CRANBROOK AVE
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3018
Practice Address - Country:US
Practice Address - Phone:440-787-8138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRA1372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology