Provider Demographics
NPI:1255475737
Name:SWENDRIS, RONALD P (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:P
Last Name:SWENDRIS
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 1:1545 HAND AVE STE B3
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1140
Mailing Address - Country:US
Mailing Address - Phone:386-673-3939
Mailing Address - Fax:904-683-3934
Practice Address - Street 1:1545 HAND AVE STE B3
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1140
Practice Address - Country:US
Practice Address - Phone:386-673-3939
Practice Address - Fax:904-683-3934
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2025-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406867207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH32001008Medicaid
VT1019782Medicaid
MI1255475737Medicaid
NHJ1336802Medicare PIN
NHJ1336801Medicare PIN