Provider Demographics
NPI:1922108968
Name:FELDMAN, ALAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10333 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-4210
Mailing Address - Country:US
Mailing Address - Phone:727-392-0199
Mailing Address - Fax:727-392-1399
Practice Address - Street 1:10333 SEMINOLE BLVD
Practice Address - Street 2:SUITE #3
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-4210
Practice Address - Country:US
Practice Address - Phone:727-392-0199
Practice Address - Fax:727-392-1399
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME739282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 73928OtherLICENSE
FL043710580OtherTAX IDENTIFICATION NUMBER
FL259478100Medicaid
FL259478100Medicaid
FL1972797363Medicare NSC
FL043710580OtherTAX IDENTIFICATION NUMBER