Provider Demographics
NPI:1013427855
Name:JASON ALTMAN MD PA
Entity Type:Organization
Organization Name:JASON ALTMAN MD PA
Other - Org Name:JASON ALTMAN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-721-7337
Mailing Address - Street 1:550 BILTMORE WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5779
Mailing Address - Country:US
Mailing Address - Phone:631-721-7337
Mailing Address - Fax:631-909-8669
Practice Address - Street 1:550 BILTMORE WAY STE 120
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5779
Practice Address - Country:US
Practice Address - Phone:631-721-7337
Practice Address - Fax:631-909-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101023208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty