Provider Demographics
NPI:1992793608
Name:DEAN, ALEEM U (MD)
Entity type:Individual
Prefix:
First Name:ALEEM
Middle Name:U
Last Name:DEAN
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 1:8000 RED BUG LAKE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9265
Mailing Address - Country:US
Mailing Address - Phone:407-366-6004
Mailing Address - Fax:407-366-6919
Practice Address - Street 1:8000 RED BUG LAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9265
Practice Address - Country:US
Practice Address - Phone:407-366-6004
Practice Address - Fax:407-366-6919
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00759528OtherMEDICARE RAILROAD
FL28739OtherBLUE CROSS BLUE SHIELD OF FLORIDA
FL273451600Medicaid
FLH94443Medicare UPIN
FL28739XMedicare PIN
FL28739OtherBLUE CROSS BLUE SHIELD OF FLORIDA