Basic Information
| Provider Information | |||||||||
| NPI: | 1770518524 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWARTZ | ||||||||
| FirstName: | SIDNEY | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1094 MILITARY TRL | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334587021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616226111 | ||||||||
| FaxNumber: | 8552159930 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 SE OCEAN BLVD | ||||||||
| Address2: | SUITE100 | ||||||||
| City: | STUART | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349963332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7722232115 | ||||||||
| FaxNumber: | 7722232887 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 06/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | ME0063460 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 18860 | 01 | FL | BCBS OF FLORIDA | OTHER | 18860V | 01 | FL | MEDICARE - PAIN CLINIC 08 | OTHER | 377121100 | 05 | FL | MEDICAID |