Provider Demographics
NPI:1215978846
Name:HARTSTEIN, ALAN (DPM)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:HARTSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11380 PROSPERITY FARMS RD STE 221E
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3465
Mailing Address - Country:US
Mailing Address - Phone:561-848-7722
Mailing Address - Fax:561-848-7812
Practice Address - Street 1:11380 PROSPERITY FARMS RD STE 221E
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3465
Practice Address - Country:US
Practice Address - Phone:561-848-7722
Practice Address - Fax:561-848-7812
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2197213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056490700Medicaid
FLU22789Medicare UPIN
FL65209Medicare PIN