Provider Demographics
NPI:1003962184
Name:SERURE, ALAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:SERURE
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 1:7300 S.W. 62 PLACE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143
Mailing Address - Country:US
Mailing Address - Phone:305-669-0184
Mailing Address - Fax:305-669-0720
Practice Address - Street 1:7300 S.W. 62 PLACE
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-669-0184
Practice Address - Fax:305-669-0720
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME374232086S0122X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96759Medicare ID - Type UnspecifiedPROVIDER #
FLD63983Medicare UPIN