Provider Demographics
NPI:1477642544
Name:D'ALESSANDRO, DAVID ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARTHUR
Last Name:D'ALESSANDRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 E. SAMPLE ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7537
Mailing Address - Country:US
Mailing Address - Phone:954-943-2480
Mailing Address - Fax:954-943-2481
Practice Address - Street 1:2211 E. SAMPLE ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-7537
Practice Address - Country:US
Practice Address - Phone:954-943-2480
Practice Address - Fax:954-943-2481
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME201212086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD21440Medicare UPIN