Provider Demographics
NPI:1336182401
Name:YESNER, ALAN J (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:YESNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1500 NW 12TH AVE
Mailing Address - Street 2:JMT-EAST 1007
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1051
Mailing Address - Country:US
Mailing Address - Phone:305-243-4664
Mailing Address - Fax:305-243-9927
Practice Address - Street 1:4801 N FEDERAL HWY
Practice Address - Street 2:102
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4618
Practice Address - Country:US
Practice Address - Phone:954-493-8666
Practice Address - Fax:954-938-4412
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-01-15
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Provider Licenses
StateLicense IDTaxonomies
FLME0030930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63105Medicare UPIN
FL94039Medicare PIN