Provider Demographics
NPI:1558184556
Name:SWANUR LLC
Entity type:Organization
Organization Name:SWANUR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED WAJAHAT
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-797-9677
Mailing Address - Street 1:11451 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-7367
Mailing Address - Country:US
Mailing Address - Phone:352-797-9677
Mailing Address - Fax:352-600-8913
Practice Address - Street 1:11451 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-7367
Practice Address - Country:US
Practice Address - Phone:352-797-9677
Practice Address - Fax:352-600-8913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty