Provider Demographics
NPI:1972797132
Name:SWARTZ, ELLEANOR SAPIN (PA-C)
Entity Type:Individual
Prefix:
First Name:ELLEANOR
Middle Name:SAPIN
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 3RD ST S
Mailing Address - Street 2:STE 200
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-6097
Mailing Address - Country:US
Mailing Address - Phone:904-249-6110
Mailing Address - Fax:904-249-6119
Practice Address - Street 1:3200 3RD ST S
Practice Address - Street 2:STE 200
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-6097
Practice Address - Country:US
Practice Address - Phone:904-249-6110
Practice Address - Fax:904-249-6119
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104222363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical