Provider Demographics
NPI:1639182629
Name:SWINFORD, JOHN MARK (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:SWINFORD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5476 W BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-6114
Mailing Address - Country:US
Mailing Address - Phone:386-274-8023
Mailing Address - Fax:
Practice Address - Street 1:3901 E COLONIAL DR STE C
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5245
Practice Address - Country:US
Practice Address - Phone:407-989-4427
Practice Address - Fax:407-898-2903
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31028183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist