Provider Demographics
NPI:1285934166
Name:ALAN GUMER M.D. P.A.
Entity type:Organization
Organization Name:ALAN GUMER M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-522-3360
Mailing Address - Street 1:PO BOX 450729
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33345-0729
Mailing Address - Country:US
Mailing Address - Phone:954-522-3360
Mailing Address - Fax:305-675-0492
Practice Address - Street 1:1001 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3148
Practice Address - Country:US
Practice Address - Phone:954-522-3360
Practice Address - Fax:305-675-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0022101273R00000X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053817500Medicaid
FL91991Medicare PIN
FLD59894Medicare UPIN