Provider Demographics
NPI:1487792792
Name:FLORIDA ANESTHESIA & PAIN MANAGEMENT ASSOCIATES, LLC
Entity type:Organization
Organization Name:FLORIDA ANESTHESIA & PAIN MANAGEMENT ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-645-1847
Mailing Address - Street 1:483 N SEMORAN BLVD
Mailing Address - Street 2:SUITE #205
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3800
Mailing Address - Country:US
Mailing Address - Phone:407-215-6320
Mailing Address - Fax:321-274-0322
Practice Address - Street 1:255 CITRUS TOWER BLVD
Practice Address - Street 2:SUITE #100
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-4421
Practice Address - Country:US
Practice Address - Phone:352-536-6340
Practice Address - Fax:352-536-1673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP3300X
FL261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHE881AMedicare PIN