Provider Demographics
NPI:1356886790
Name:SOUTHWEST FLORIDA MEDICINE PLLC
Entity type:Organization
Organization Name:SOUTHWEST FLORIDA MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PARVEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LALANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-659-2718
Mailing Address - Street 1:PO BOX 21116
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34204-1116
Mailing Address - Country:US
Mailing Address - Phone:941-877-7000
Mailing Address - Fax:
Practice Address - Street 1:2902 59TH ST W
Practice Address - Street 2:SUITE C
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7021
Practice Address - Country:US
Practice Address - Phone:941-877-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty