Provider Demographics
NPI:1467419564
Name:ALBRITTON, ALVO OWEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALVO
Middle Name:OWEN
Last Name:ALBRITTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4840
Mailing Address - Country:US
Mailing Address - Phone:863-647-3929
Mailing Address - Fax:
Practice Address - Street 1:627 ROBIN RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4840
Practice Address - Country:US
Practice Address - Phone:863-647-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0002401213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU41219Medicare UPIN
FL65357Medicare ID - Type Unspecified