Provider Demographics
NPI:1720068364
Name:ALTMAN, ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EDGEWATER DR APT 4H
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6963
Mailing Address - Country:US
Mailing Address - Phone:786-246-0971
Mailing Address - Fax:
Practice Address - Street 1:2001 W 68TH ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1801
Practice Address - Country:US
Practice Address - Phone:305-823-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0027843207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00174224OtherRRMCR
FL92704OtherBCBS
FL92704CMedicare ID - Type Unspecified
FLC12786Medicare UPIN
FL92704EMedicare ID - Type UnspecifiedMEDICARE