Provider Demographics
NPI:1760585707
Name:LEFKIN, ALAN STEWART (MD FACP)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:STEWART
Last Name:LEFKIN
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7918 SHENANDOAH LANE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067
Mailing Address - Country:US
Mailing Address - Phone:954-341-1376
Mailing Address - Fax:954-341-1376
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE 401
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-447-9844
Practice Address - Fax:954-447-5084
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E21403Medicare UPIN
0770SAMedicare ID - Type Unspecified