Provider Demographics
NPI:1275574865
Name:SHERMAN, ALAN BRUCE (DO)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:BRUCE
Last Name:SHERMAN
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 1:2 MIDWAY IS
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2311
Mailing Address - Country:US
Mailing Address - Phone:727-786-8789
Mailing Address - Fax:
Practice Address - Street 1:11375 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34613-5409
Practice Address - Country:US
Practice Address - Phone:352-597-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4994207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D60737Medicare UPIN