Provider Demographics
NPI:1487640256
Name:GITTMAN, ALLAN (MD)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:GITTMAN
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 1:3333 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6741
Mailing Address - Country:US
Mailing Address - Phone:954-941-8866
Mailing Address - Fax:954-941-9950
Practice Address - Street 1:3333 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6741
Practice Address - Country:US
Practice Address - Phone:954-941-8866
Practice Address - Fax:954-941-9950
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04616VOtherMEDICARE PTAN
FLME0051209OtherMEDICAL LIC.#
FLME0051209OtherMEDICAL LIC.#
FL04616VOtherMEDICARE PTAN