Provider Demographics
NPI:1083715171
Name:HALPREN, EDWARD WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WILLIAM
Last Name:HALPREN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14271 METROPOLIS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4302
Mailing Address - Country:US
Mailing Address - Phone:239-561-2200
Mailing Address - Fax:239-561-2491
Practice Address - Street 1:14271 METROPOLIS AVE STE B
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4302
Practice Address - Country:US
Practice Address - Phone:239-561-2200
Practice Address - Fax:239-561-2491
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005272207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047104600Medicaid
FL80024OtherBLUE CROSS BLUE SHIELD
FL80024OtherBLUE CROSS BLUE SHIELD
FL80024ZMedicare ID - Type Unspecified