Provider Demographics
NPI:1609036854
Name:HAMILTON, ALAN SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:SCOTT
Last Name:HAMILTON
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 1:8350 BEE RIDGE RD # 358
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-6312
Mailing Address - Country:US
Mailing Address - Phone:512-845-6346
Mailing Address - Fax:
Practice Address - Street 1:3280 LAKE POINTE BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:941-666-9512
Practice Address - Fax:888-507-0227
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109180208100000X
TXP3633208100000X
GA66694208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB160159Medicare PIN
FL003753100Medicaid