Provider Demographics
NPI:1679187744
Name:SWCA RHEUMATOLOGY LLC
Entity Type:Organization
Organization Name:SWCA RHEUMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-456-8900
Mailing Address - Street 1:1250 E HALLANDALE BEACH BLVD STE 605
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4638
Mailing Address - Country:US
Mailing Address - Phone:954-456-8900
Mailing Address - Fax:954-457-9118
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD STE 605
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4638
Practice Address - Country:US
Practice Address - Phone:954-456-8900
Practice Address - Fax:954-457-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty