Provider Demographics
NPI:1235654542
Name:ALAN O. MARAMARA, OD, PA
Entity Type:Organization
Organization Name:ALAN O. MARAMARA, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:HLUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-886-2020
Mailing Address - Street 1:25 W COLLEGE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-4701
Mailing Address - Country:US
Mailing Address - Phone:1813-886-2020
Mailing Address - Fax:
Practice Address - Street 1:25 W COLLEGE AVE STE D
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-4701
Practice Address - Country:US
Practice Address - Phone:1813-886-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001058700Medicaid