Provider Demographics
NPI:1891732186
Name:SWANA, HUBERT S (MD)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:S
Last Name:SWANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 COOK AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2911
Mailing Address - Country:US
Mailing Address - Phone:321-843-9017
Mailing Address - Fax:321-843-9019
Practice Address - Street 1:1725 COOK AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2911
Practice Address - Country:US
Practice Address - Phone:321-843-9017
Practice Address - Fax:321-843-9019
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83553208000000X
FLME82793208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70126FMedicaid
FL273648900Medicaid
FLME82793OtherMEDICAL LICENSE
CAFHC70126FMedicaid
FLME82793OtherMEDICAL LICENSE
FL28792WMedicare PIN