Provider Demographics
NPI:1235287731
Name:CADIZ, ALAN (DO)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:CADIZ
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 1:9750 NW 33RD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4042
Mailing Address - Country:US
Mailing Address - Phone:954-752-9220
Mailing Address - Fax:954-755-5025
Practice Address - Street 1:9750 NW 33RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4042
Practice Address - Country:US
Practice Address - Phone:954-752-9220
Practice Address - Fax:954-755-5025
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO1487208000000X
FLOS10683208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA162617760AMedicaid
FL0014451-00Medicaid
GA162617760AMedicaid