1689663296 NPI number — JEFFREY A ALPER MD P A

Table of content: JEFFREY A ALPER MD P A (NPI 1689663296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689663296 NPI number — JEFFREY A ALPER MD P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALPER
Provider First Name:
JEFFREY
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD P A
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689663296
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
689 9TH ST N
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34102-8100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-262-6550
Provider Business Mailing Address Fax Number:
239-261-9658

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
689 9TH ST N
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34102-8100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-262-6550
Provider Business Practice Location Address Fax Number:
239-261-9658
Provider Enumeration Date:
10/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  ME39139 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 046220900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00056783 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ME39139 . This is a "LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 111508300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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