Provider Demographics
NPI:1649266131
Name:SWEARINGEN, KAREN (OD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:SWEARINGEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 NAVARRE PKWY
Mailing Address - Street 2:WALMART VISION CENTER
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-2910
Mailing Address - Country:US
Mailing Address - Phone:850-939-0947
Mailing Address - Fax:850-939-3447
Practice Address - Street 1:9360 NAVARRE PKWY
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2910
Practice Address - Country:US
Practice Address - Phone:850-939-0947
Practice Address - Fax:850-939-3447
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2733152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
U49387Medicare UPIN
FL20491Medicare ID - Type Unspecified