Individual
PAUL MATHEW SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1871 SE TIFFANY AVE, SUITE 100, PORT ST LUCIE, FL 34952-7585
(772) 335-5666
(772) 335-4826
Mailing address
1871 SE TIFFANY AVE, SUITE 100, PORT ST LUCIE, FL 34952-7585
(772) 335-5666
(772) 335-4826
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0075493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075493
STATE LICENSE NUMBER
FL
05
—
254047900
—
FL
01
—
43952
BLUE CROSS BLUE SHIELD
FL
01
—
900002186
RAILROAD MEDICARE
FL
Enumeration date
05/26/2006
Last updated
07/14/2010
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