Provider Demographics
NPI:1235148743
Name:SPIEGEL, ALLAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:M
Last Name:SPIEGEL
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 1:31608 US 19 NORTH
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684
Mailing Address - Country:US
Mailing Address - Phone:727-787-7077
Mailing Address - Fax:727-786-6588
Practice Address - Street 1:31608 US 19 NORTH
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684
Practice Address - Country:US
Practice Address - Phone:727-787-7077
Practice Address - Fax:727-786-6588
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME450632084N0400X
FLME00450632083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
6518029009OtherCIGNA
FL5332550001OtherDME
4209511OtherAETNA
6518029009OtherCIGNA
E14492Medicare UPIN