Basic Information
| Provider Information | |||||||||
| NPI: | 1932174349 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWANSON | ||||||||
| FirstName: | ROZALES | ||||||||
| MiddleName: | ANTONIO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 E FLETCHER AVE STE 320 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336134645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139100027 | ||||||||
| FaxNumber: | 8139711286 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 E FLETCHER AVE STE 320 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336134645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139100027 | ||||||||
| FaxNumber: | 8139711286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2006 | ||||||||
| LastUpdateDate: | 11/09/2017 | ||||||||
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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 | 208G00000X | ME93579 | FL | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 4301097550 | MI | N | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2086S0129X | 0101238070 | VA | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.