Provider Demographics
NPI:1255367371
Name:SWERDLOFF, JASON L (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:SWERDLOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8220 US 19 NORTH
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668
Mailing Address - Country:US
Mailing Address - Phone:727-841-8505
Mailing Address - Fax:727-846-0561
Practice Address - Street 1:8220 US 19 NORTH
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668
Practice Address - Country:US
Practice Address - Phone:727-841-8505
Practice Address - Fax:727-846-0561
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78372207Y00000X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261676900Medicaid
F96916Medicare UPIN
46837ZMedicare ID - Type Unspecified