Provider Demographics
NPI:1356306781
Name:UROLOGY TREATMENT CENTER OF SOUTHWEST FL, PA
Entity Type:Organization
Organization Name:UROLOGY TREATMENT CENTER OF SOUTHWEST FL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TREIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-917-8488
Mailing Address - Street 1:1921 WALDEMERE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2943
Mailing Address - Country:US
Mailing Address - Phone:941-917-8488
Mailing Address - Fax:941-917-8475
Practice Address - Street 1:1921 WALDEMERE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2943
Practice Address - Country:US
Practice Address - Phone:941-917-8488
Practice Address - Fax:941-917-8475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
FL=========OtherTAX ID