Provider Demographics
NPI:1326028630
Name:SIEGEL, ALAN RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:RICHARD
Last Name:SIEGEL
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 1:7447 NORTH UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2970
Mailing Address - Country:US
Mailing Address - Phone:954-722-6200
Mailing Address - Fax:954-721-4200
Practice Address - Street 1:7447 NORTH UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2970
Practice Address - Country:US
Practice Address - Phone:954-722-6200
Practice Address - Fax:954-721-4200
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57372207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17961OtherBCBS OF FL
FL371856500Medicaid
FL371856500Medicaid
FL17961YMedicare PIN
FL17961RMedicare PIN
FL17961ZMedicare PIN
FL17961OtherBCBS OF FL
FL17961XMedicare PIN
FL17961SMedicare PIN
FL17961TMedicare PIN
CO448288Medicare PIN
FL17961WMedicare PIN