Provider Demographics
NPI:1821024829
Name:GITTLEMAN, ADAM M (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:M
Last Name:GITTLEMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:DEPT AT 952288
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31192-0001
Mailing Address - Country:US
Mailing Address - Phone:305-503-5610
Mailing Address - Fax:305-503-6320
Practice Address - Street 1:5301 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1149
Practice Address - Country:US
Practice Address - Phone:561-548-3727
Practice Address - Fax:561-548-1238
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME902672085R0202X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI33850Medicare UPIN