Provider Demographics
NPI:1346525128
Name:OZERAN, ALLEN (DO)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:OZERAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 S OCEAN DR APT 817A
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-2068
Mailing Address - Country:US
Mailing Address - Phone:310-625-3224
Mailing Address - Fax:
Practice Address - Street 1:7380 S OCEAN DR APT 817A
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-2068
Practice Address - Country:US
Practice Address - Phone:310-625-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14932207RG0100X
CA20A12467207RG0100X
VA0102202970207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346525128Medicaid