Provider Demographics
NPI:1629425533
Name:TROUM, ALEXANDER P (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:P
Last Name:TROUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 CENTRAL AVE UNIT 512
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3661
Mailing Address - Country:US
Mailing Address - Phone:609-602-6649
Mailing Address - Fax:
Practice Address - Street 1:4420 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2164
Practice Address - Country:US
Practice Address - Phone:863-385-2248
Practice Address - Fax:863-382-1242
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
FLOS18399207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT3304OtherMEDICARE HF
FL114360300Medicaid