Provider Demographics
NPI:1831388164
Name:ALAN R SCHNEIDER LAUDERDALE UROLOGY
Entity type:Organization
Organization Name:ALAN R SCHNEIDER LAUDERDALE UROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-772-1220
Mailing Address - Street 1:5301 N DIXIE HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3447
Mailing Address - Country:US
Mailing Address - Phone:954-772-1220
Mailing Address - Fax:
Practice Address - Street 1:5301 N DIXIE HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4148
Practice Address - Country:US
Practice Address - Phone:954-772-1220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42343208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCC1901OtherRAILROAD MEDICARE
FLCC1901OtherRAILROAD MEDICARE