Provider Demographics
NPI:1912076159
Name:SLOAN, DEAN ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ALAN
Last Name:SLOAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 NE 4TH AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4565
Mailing Address - Country:US
Mailing Address - Phone:561-330-7878
Mailing Address - Fax:561-330-7998
Practice Address - Street 1:74 NE 4TH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4565
Practice Address - Country:US
Practice Address - Phone:561-330-7878
Practice Address - Fax:561-330-7998
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056952207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10563AMedicare ID - Type UnspecifiedPROVIDER NUMBER