Provider Demographics
NPI:1609043272
Name:SOUTHWEST ANESTHESIA AND PAIN MANAGEMENT PA
Entity Type:Organization
Organization Name:SOUTHWEST ANESTHESIA AND PAIN MANAGEMENT PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CYPRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-345-0065
Mailing Address - Street 1:5979 VINELAND RD STE 207
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7855
Mailing Address - Country:US
Mailing Address - Phone:407-456-2711
Mailing Address - Fax:407-345-0063
Practice Address - Street 1:5979 VINELAND RD STE 207
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7855
Practice Address - Country:US
Practice Address - Phone:407-345-0065
Practice Address - Fax:407-345-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207LP2900X
FL1052652261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL684Medicare PIN