Provider Demographics
NPI: | 1386927432 |
---|---|
Name: | ALAN R SINGER MD LLC |
Entity type: | Organization |
Organization Name: | ALAN R SINGER MD LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ALAN |
Authorized Official - Middle Name: | R |
Authorized Official - Last Name: | SINGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 813-962-6700 |
Mailing Address - Street 1: | PO BOX 22606 |
Mailing Address - Street 2: | |
Mailing Address - City: | TAMPA |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33622-2606 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-962-6700 |
Mailing Address - Fax: | 813-962-7799 |
Practice Address - Street 1: | 17511 N DALE MABRY HWY |
Practice Address - Street 2: | |
Practice Address - City: | LUTZ |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33548-4521 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-962-6700 |
Practice Address - Fax: | 813-962-7799 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-09-26 |
Last Update Date: | 2012-02-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | FS762A | Medicare PIN |