Basic Information
| Provider Information | |||||||||
| NPI: | 1366670705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWARTZLANDER | ||||||||
| FirstName: | TY | ||||||||
| MiddleName: | KAINE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1880 N CONGRESS AVE | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334268671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614132832 | ||||||||
| FaxNumber: | 8887346559 | ||||||||
| Practice Location | |||||||||
| Address1: | 1880 N CONGRESS AVE | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334268671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614132832 | ||||||||
| FaxNumber: | 8887346559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2009 | ||||||||
| LastUpdateDate: | 08/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME 116051 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 009357600 | 05 | FL | MEDICAID |