Provider Demographics
NPI:1689853376
Name:ALAN J KNAPP MD PA
Entity Type:Organization
Organization Name:ALAN J KNAPP MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-474-2266
Mailing Address - Street 1:1500 PLACIDA RD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223
Mailing Address - Country:US
Mailing Address - Phone:941-474-2266
Mailing Address - Fax:941-475-7274
Practice Address - Street 1:1500 PLACIDA RD
Practice Address - Street 2:SUITE B2
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4955
Practice Address - Country:US
Practice Address - Phone:941-474-2266
Practice Address - Fax:941-475-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45535207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0854700002OtherCIGNA GOVERNMENT SERVICES
FL263964500Medicaid
FLDA6578OtherRAILROAD MEDICARE
FLK8640Medicare PIN
FL263964500Medicaid
FL0854700002Medicare NSC