MEDICARE: VLAICU ALIN BOTOMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	ME67172	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386670677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VLAICU ALIN BOTOMAN MD

Provider Business Mailing Address
First Line	:	2021 E COMMERCIAL BLVD
Second Line	:	SUITE 202
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3763
Country	:	US
Telephone Number	:	954-202-7850
Fax Number	:	954-202-7781

Provider Business Practice Location Address
First Line	:	2021 E COMMERCIAL BLVD
Second Line	:	SUITE 202
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33136-1005
Country	:	US
Telephone Number	:	954-202-7850
Fax Number	:	954-202-7781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	07/08/2007

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