Provider Demographics
NPI:1831954692
Name:SWAN CITY EYE CARE
Entity type:Organization
Organization Name:SWAN CITY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GARIBAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-503-4232
Mailing Address - Street 1:3804 ALAMANDA HILLS LN
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-7804
Mailing Address - Country:US
Mailing Address - Phone:813-503-4232
Mailing Address - Fax:
Practice Address - Street 1:6631 S. FLORIDA AVE
Practice Address - Street 2:UNITS 603, 604
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813
Practice Address - Country:US
Practice Address - Phone:813-503-4232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty