Provider Demographics
NPI:1275580185
Name:BAKST, ALAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:E
Last Name:BAKST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5401 S CONGRESS AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6637
Mailing Address - Country:US
Mailing Address - Phone:561-967-4118
Mailing Address - Fax:561-967-3463
Practice Address - Street 1:5401 S CONGRESS AVE
Practice Address - Street 2:# 204
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6635
Practice Address - Country:US
Practice Address - Phone:561-967-4118
Practice Address - Fax:561-967-3463
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036051310207RP1001X, 207RC0200X
VA0101255502207RC0200X
FLME79475207RP1001X
NC2014-01915207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275580185Medicaid
NC1275580185Medicaid
FL262867800Medicaid
VA1275580185Medicaid
NC1275580185Medicaid
FLH01640Medicare UPIN