Provider Demographics
NPI:1477516623
Name:FEINGOLD, ILAN ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ILAN
Middle Name:ALLAN
Last Name:FEINGOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6200 SUNSET DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4828
Mailing Address - Country:US
Mailing Address - Phone:305-662-1550
Mailing Address - Fax:305-662-5930
Practice Address - Street 1:6200 SUNSET DR
Practice Address - Street 2:SUITE 304
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4828
Practice Address - Country:US
Practice Address - Phone:305-662-1550
Practice Address - Fax:305-662-5930
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39452207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95923Medicare ID - Type Unspecified
FLE15847Medicare UPIN