Provider Demographics
NPI:1265743082
Name:SWFL MEDICAL PARTNERS LLC
Entity type:Organization
Organization Name:SWFL MEDICAL PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-480-0200
Mailing Address - Street 1:401 COMMERCIAL CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1652
Mailing Address - Country:US
Mailing Address - Phone:941-480-0200
Mailing Address - Fax:941-485-8404
Practice Address - Street 1:401 COMMERCIAL CT
Practice Address - Street 2:SUITE D
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1652
Practice Address - Country:US
Practice Address - Phone:941-480-0200
Practice Address - Fax:941-485-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2012-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8549261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain