Provider Demographics
NPI:1972797363
Name:ALAN D. FELDMAN, M.D.P.A.
Entity type:Organization
Organization Name:ALAN D. FELDMAN, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WISNIEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-392-6200
Mailing Address - Street 1:10333 SEMINOLE BLVD
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-4210
Mailing Address - Country:US
Mailing Address - Phone:727-392-0199
Mailing Address - Fax:727-392-1399
Practice Address - Street 1:10333 SEMINOLE BLVD
Practice Address - Street 2:SUITE # 3
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-4210
Practice Address - Country:US
Practice Address - Phone:727-392-0199
Practice Address - Fax:727-392-1399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME739282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME73928OtherM.D LICENSE
FL259478100Medicaid
FLBF552786OtherDEA
FLH19073Medicare UPIN