Provider Demographics
NPI:1538415112
Name:SWANICK, CAMERON WILLIAMS (MD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:WILLIAMS
Last Name:SWANICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S ORANGE AVE # MP760-22
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2134
Mailing Address - Country:US
Mailing Address - Phone:321-841-8650
Mailing Address - Fax:321-841-3794
Practice Address - Street 1:1400 S ORANGE AVE # MP760-22
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2134
Practice Address - Country:US
Practice Address - Phone:321-841-8650
Practice Address - Fax:321-841-3794
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1322572085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020798200Medicaid