Provider Demographics
NPI:1306985916
Name:ANHALT, STEVEN MARK (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:ANHALT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:10064 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3309
Practice Address - Country:US
Practice Address - Phone:954-680-9334
Practice Address - Fax:954-680-9985
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOPC2160152WC0802X, 152WS0006X, 152WX0102X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT77519Medicare UPIN