Provider Demographics
NPI:1750722153
Name:SWINDLING, ROBERT WENDELL (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WENDELL
Last Name:SWINDLING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13170 ATLANTIC BLVD STE 47
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6149
Mailing Address - Country:US
Mailing Address - Phone:904-221-0024
Mailing Address - Fax:
Practice Address - Street 1:13170 ATLANTIC BLVD STE 47
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-6149
Practice Address - Country:US
Practice Address - Phone:904-221-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2013-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15534183500000X
FLPU2078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist