Provider Demographics
NPI:1831292721
Name:BEZNER, ALLEN H (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:H
Last Name:BEZNER
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 1:116 JFK DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6606
Mailing Address - Country:US
Mailing Address - Phone:561-439-1234
Mailing Address - Fax:561-439-0506
Practice Address - Street 1:116 JFK DRIVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6606
Practice Address - Country:US
Practice Address - Phone:561-439-1234
Practice Address - Fax:561-439-0506
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38678174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4099722OtherAETNA
FL02977OtherWELLCARE/STAYWELL
FL071095OtherAV MED
FL1003492OtherCAREPLUS
FL02977OtherHEALTHEASE
FL5945OtherNEIGHBORHOOD HEALTH PLAN
FL96393OtherBCBS FL / HEALTH OPTIONS
FL02977OtherHEALTHEASE
FL4099722OtherAETNA