Provider Demographics
NPI:1689775868
Name:SWEARINGEN, MELVIN H (CRNA)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:H
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HAROLD LANE
Mailing Address - Street 2:
Mailing Address - City:BLAIRESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-8376
Mailing Address - Country:US
Mailing Address - Phone:352-668-4272
Mailing Address - Fax:
Practice Address - Street 1:14547 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2709
Practice Address - Country:US
Practice Address - Phone:813-978-1494
Practice Address - Fax:813-615-0296
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP767252367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00669508OtherRR MEDICARE
FLG0422Q - PASCOMedicare PIN
FLG0422U - TPAMedicare PIN