1962773556 NPI number — A PLACE FOR GROWTH

Table of content: DR. MICHAEL SHANE SWITZER D.O. (NPI 1215290192)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962773556 NPI number — A PLACE FOR GROWTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A PLACE FOR GROWTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962773556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1625 N COMMERCE PKWY
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33326-3216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-384-9373
Provider Business Mailing Address Fax Number:
954-384-9581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1625 N COMMERCE PKWY
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33326-3216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-384-9373
Provider Business Practice Location Address Fax Number:
954-384-9581
Provider Enumeration Date:
01/13/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GASTESI-DEARMAS
Authorized Official First Name:
ALINA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/ CLINICAL DIRECTOR
Authorized Official Telephone Number:
954-384-9373

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)