Provider Demographics
NPI:1639266034
Name:SHUSTER, ALAN ROGER (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROGER
Last Name:SHUSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:550 HERITAGE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3030
Mailing Address - Country:US
Mailing Address - Phone:561-425-7070
Mailing Address - Fax:561-453-2666
Practice Address - Street 1:550 HERITAGE DR STE 202
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3030
Practice Address - Country:US
Practice Address - Phone:561-425-7070
Practice Address - Fax:561-453-2666
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055016207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ7PY7OtherBLUE CROSS BLUE SHIELD
FLDW2570OtherRAILROAD MEDICARE
FLIK466AMedicare UPIN
FL0538701-00Medicaid
FL180015157OtherRAILROAD MEDICARE