Provider Demographics
NPI:1124185327
Name:SIEGEL, ALAN BERNARD (RPH CRPH PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:BERNARD
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:RPH CRPH PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 NW 58 WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067
Mailing Address - Country:US
Mailing Address - Phone:954-255-6499
Mailing Address - Fax:954-255-5692
Practice Address - Street 1:6111 NW 58 WAY
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067
Practice Address - Country:US
Practice Address - Phone:954-255-6499
Practice Address - Fax:954-255-5692
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS17708183500000X
FLPA30681835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric