1972797363 NPI number — ALAN D. FELDMAN, M.D.P.A.

Table of content: (NPI 1972797363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972797363 NPI number — ALAN D. FELDMAN, M.D.P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAN D. FELDMAN, M.D.P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1972797363
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10333 SEMINOLE BLVD
Provider Second Line Business Mailing Address:
SUITE # 3
Provider Business Mailing Address City Name:
LARGO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33778-4210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-392-0199
Provider Business Mailing Address Fax Number:
727-392-1399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10333 SEMINOLE BLVD
Provider Second Line Business Practice Location Address:
SUITE # 3
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33778-4210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-392-0199
Provider Business Practice Location Address Fax Number:
727-392-1399
Provider Enumeration Date:
08/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WISNIEWSKI
Authorized Official First Name:
DORA
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
OFFICE COORDINATOR
Authorized Official Telephone Number:
727-392-6200

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  ME73928 , 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: ME73928 . This is a "M.D LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 259478100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com